CN104955413A

CN104955413A - Bipolar electrosurgical hand shears

Info

Publication number: CN104955413A
Application number: CN201480006484.9A
Authority: CN
Inventors: C·O·巴克斯特三世; D·C·耶茨; K·J·施米德; T·W·阿伦霍尔特; J·S·斯韦兹; J·D·梅瑟利; M·S·克罗珀; J·R·摩根; C·P·布德罗克斯; R·W·蒂姆; F·E·谢尔顿四世
Original assignee: Ethicon Endo Surgery Inc
Current assignee: Ethicon Endo Surgery Inc
Priority date: 2013-01-29
Filing date: 2014-01-15
Publication date: 2015-09-30
Anticipated expiration: 2034-01-15
Also published as: CN104955413B; JP2016504153A; US20170224409A1; US20140214019A1; US10813683B2; JP6316849B2; US9610114B2; US20180008337A1; US10945782B2; WO2014120442A2; EP2950732A2; WO2014120442A3; EP2950732B1

Abstract

The present invention provides an apparatus, which comprises a first jaw, a second jaw, a first handle, and a second handle. The second jaw is pivotally coupled with the first jaw. The first jaw and the second jaw are configured to grasp tissue. The jaws provide offset electrode surfaces that are operable to deliver bipolar RF energy to tissue grasped between the jaws. The apparatus is further operable to sever tissue. A lockout feature selectively prevents tissue severing, based on an energization state of the jaws.

Description

Bipolar electrosurgical hand shears

Background technology

Multiple surgical instruments comprises one or more elements radio-frequency (RF) energy being transferred to tissue (such as, to solidify or seal tissue).Some these type of apparatuses comprise a pair jaw of open and close organizationally and have the electric conductivity tissue contacting surface that can operate with the tissue of weld clamp between jaw.In open surgical environment, some these type of apparatuses can be the form of the clamp with scissor grip part.

Except having radio-frequency (RF) energy transfer element, some surgical instrumenties also comprise parallel-moving type and organize cutting element.The example of such device is Ethicon Endo-Surgery, Inc.'s (Cincinnati, Ohio) tissue encapsulation device.The other example of such device and related notion are disclosed in following United States Patent (USP): the name of December 31 announcement in 2002 is called the United States Patent (USP) 6 of " Electrosurgical Systems and Techniques for Sealing Tissue ", 500,176, the disclosure of this patent is incorporated herein by reference; The name of JIUYUE in 2006 announcement on the 26th is called the United States Patent (USP) 7,112,201 of " Electrosurgical Instrument and Method of Use ", and its disclosure is incorporated herein by reference; The name announced on October 24th, 2006 is called the United States Patent (USP) 7,125,409 of " Electrosurgical Working End for Controlled Energy Delivery ", and its disclosure is incorporated herein by reference; The name announced on January 30th, 2007 is called the United States Patent (USP) 7,169,146 of " Electrosurgical Probe and Method of Use ", and its disclosure is incorporated herein by reference; The name announced on March 6th, 2007 is called the United States Patent (USP) 7,186,253 of " Electrosurgical Jaw Structure for Controlled Energy Delivery ", and its disclosure is incorporated herein by reference; The name announced on March 13rd, 2007 is called the U.S. Patent No. 7,189,233 of " Electrosurgical Instrument ", and its disclosure is incorporated herein by reference; The name announced on May 22nd, 2007 is called the United States Patent (USP) 7,220,951 of " Surgical Sealing Surfaces and Methods of Use ", and its disclosure is incorporated herein by reference; The name of December in 2007 announcement on the 18th is called the United States Patent (USP) 7,309,849 of " Polymer Compositions Exhibiting a PTC Property and Methods of Fabrication ", and its disclosure is incorporated herein by reference; The name of December in 2007 announcement on the 25th is called the United States Patent (USP) 7,311,709 of " Electrosurgical Instrument and Method of Use ", and its disclosure is incorporated herein by reference; The name announced on April 8th, 2008 is called the United States Patent (USP) 7,354,440 of " Electrosurgical Instrument and Method of Use ", and its disclosure is incorporated herein by reference; The name announced on June 3rd, 2008 is called the United States Patent (USP) 7,381,209 of " Electrosurgical Instrument ", and its disclosure is incorporated herein by reference.

Other example of electrosurgical cut apparatus and related notion is disclosed in following patent: the name announced on April 14th, 2011 is called that the U.S. of " Surgical Instrument Comprising First and Second Drive Systems Actuatable by a Common Trigger Mechanism " announces 2011/0087218, and its disclosure is incorporated herein by reference; The name announced on May 10th, 2012 is called that the U.S. of " Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback " announces 2012/0116379, and its disclosure is incorporated herein by reference; The name announced on March 29th, 2012 is called that the U.S. of " Control Features for Articulating Surgical Device " announces 2012/0078243, and its disclosure is incorporated herein by reference; The name announced on March 29th, 2012 is called that the U.S. of " Articulation Joint Features for Articulating Surgical Device " announces 2012/0078247, and its disclosure is incorporated herein by reference; The name of JIUYUE in 2012 submission on the 19th is called the U.S. Patent application 13/622,729 of " Surgical Instrument with Multi-Phase Trigger Bias ", and its disclosure is incorporated herein by reference; Be called the U.S. Patent application 13/622,735 of " Surgical Instrument with Contained Dual Helix Actuator Assembly " with the name of JIUYUE in 2012 submission on the 19th, its disclosure is incorporated herein by reference.

Although developed and employed some medical treatment devices, it is believed that also nobody develops or use the invention described in claims before the present inventor.

Accompanying drawing explanation

Although the accompanying claims of this description particularly point out and clearly advocate this technology, it is believed that and will be better understood this technology below in conjunction with accompanying drawing to the description that some example is done, reference number similar in accompanying drawing represents similar elements, wherein:

Fig. 1 shows the perspective view of exemplary clamp apparatus;

Fig. 2 shows the side view of the apparatus of Fig. 1 in the close position;

Fig. 3 shows the side exploded view of the apparatus of Fig. 1;

Fig. 4 shows the enlarged perspective of the jaw of the apparatus of Fig. 1;

Fig. 5 shows the front section view of the jaw of Fig. 4;

Fig. 6 shows the perspective view of the exemplary alternative jaw with plug-in unit;

Fig. 7 shows the front section view of the jaw of Fig. 6;

Fig. 8 shows the perspective view of the exemplary alternative jaw with plug-in unit;

Fig. 9 shows the front section view of the jaw of Fig. 8;

Figure 10 A shows the front section view of the exemplary alternative pattern of the plug-in unit of the jaw of clamp apparatus, wherein jaw grip tissue;

Figure 10 B shows the front section view of the plug-in unit of Figure 10 A, wherein jaw weld structure;

Figure 10 C shows the front section view of the plug-in unit of Figure 10 A, and wherein jaw cuts and organizes;

Figure 11 A shows the front section view of the exemplary alternative plug-in unit of the jaw of clamp apparatus, wherein jaw grip tissue;

Figure 11 B shows the front section view of the plug-in unit of Figure 11 A, wherein jaw weld structure;

Figure 11 C shows the front section view of the plug-in unit of Figure 11 A, and wherein jaw cuts and organizes;

Figure 12 shows the perspective view of the exemplary alternative plug-in unit of the jaw of the clamp apparatus with pressure edge;

Figure 13 shows the front section view of the plug-in unit of the Figure 12 inserted in jaw;

Figure 14 shows the perspective view of the exemplary alternative plug-in unit of the jaw of the clamp apparatus inserted in jaw;

Figure 15 shows the front section view of the plug-in unit of the Figure 14 inserted in jaw;

Figure 16 shows the front section view of the exemplary alternative plug-in unit in the jaw being shaped as the clamp apparatus coordinating cutter;

Figure 17 shows along with cutter advances and the front section view of the plug-in unit of Figure 16 of grip tissue;

Figure 18 shows the perspective view of the exemplary alternative pattern of the jaw of the clamp apparatus with the electrode of locating diagonally;

Figure 19 shows the front perspective view of the jaw of Figure 18;

Figure 20 shows the perspective view of the exemplary alternative pattern with the jaw facing outer electrode;

Figure 21 shows the perspective cut-away schematic view with outer electrode and the exemplary alternative pattern of the jaw of the clamp apparatus of the I ellbeam of orientation vertically;

Figure 22 shows and is rotated counterclockwise 90 degree and the perspective cut-away schematic view being pressed against the jaw of structural Figure 21;

Figure 23 shows the perspective view of the exemplary alternative jaw of the clamp apparatus with checkerboard type profile;

Figure 24 shows the sectional view of the jaw of the Figure 23 intercepted along the line 24-24 in Figure 23;

Figure 25 shows the sectional view of the jaw of the Figure 23 intercepted along the line 25-25 in Figure 23;

Figure 26 shows the sectional view of the jaw of the Figure 23 intercepted along the line 26-26 in Figure 23;

Figure 27 shows the sectional perspective view of the exemplary alternative jaw of clamp apparatus;

Figure 28 shows the perspective view of the exemplary alternative jaw of clamp apparatus;

Figure 29 shows the perspective view of the exemplary alternative jaw of clamp apparatus;

Figure 30 shows the side view of the exemplary alternative clamp apparatus of the double-button actuating system had for being energized and cut;

Figure 31 shows the side view of the exemplary alternative clamp apparatus with two benches actuating trigger;

Figure 32 shows the side view of the exemplary alternative clamp apparatus with power-on button and cutting trigger;

Figure 33 A shows the side view had with the exemplary alternative clamp apparatus of the cutter locking trigger of power-on button one;

Figure 33 B shows the side view of the clamp apparatus of Figure 34 A, and wherein power-on button is pressed;

Figure 33 C shows the side view of the clamp apparatus of Figure 34 A, and wherein power-on button is pressed and locking trigger is pulled;

Figure 34 A shows the side view had with the exemplary alternative clamp apparatus of the cutter locking trigger of power-on button one;

Figure 34 B shows the side view of the clamp apparatus of Figure 34 A, and wherein power-on button is pressed;

Figure 34 C shows the side view of the clamp apparatus of Figure 34 A, and wherein power-on button is pressed and locking trigger is pulled;

Figure 35 shows the side view of the exemplary alternative clamp apparatus of the cutter lock with cam path operation;

Figure 36 A shows the cutter of the apparatus of Figure 35 and the side view of jaw, wherein cutter engagement cam feature structure;

Figure 36 B shows the cutter of Figure 36 A and the side view of jaw, and wherein cutter departs from cam feature structure;

Figure 37 shows the perspective view of the coupling of exemplary alternative clamp apparatus;

Figure 38 A shows the side view of the exemplary clamp apparatus of the coupling combining Figure 37, and wherein jaw is opened;

Figure 38 B shows the side view of the clamp apparatus of Figure 38 A, and wherein jaw is clamped;

Figure 38 C shows the side view of the clamp apparatus of Figure 38 A, and wherein jaw is energized;

Figure 38 D shows the side view of the clamp apparatus of Figure 38 A, and wherein cutter advances;

Figure 38 E shows the side view of the clamp apparatus of Figure 38 A, and wherein jaw is released;

Figure 39 shows the side view of the exemplary alternative clamp apparatus with cutter locking trigger;

Figure 40 A shows the partial side view of the clamp apparatus of Figure 39, and wherein jaw closes;

Figure 40 B shows the partial side view of the clamp apparatus of Figure 39, and wherein locking trigger activated;

Figure 41 shows the side view of the exemplary alternative clamp apparatus with cutter locking feature structure;

Figure 42 A shows the partial side view of the clamp apparatus of Figure 41, and wherein jaw closes;

Figure 42 B shows the partial side view of the clamp apparatus of Figure 41, and wherein trigger departs from shank and cutter propelling;

Figure 42 C shows the partial side view of the clamp apparatus of Figure 41, and wherein jaw is released;

Figure 43 A shows the side view of the exemplary alternative clamp apparatus with cutter locking trigger;

Figure 43 B shows the side view of the clamp apparatus of Figure 43 A, and wherein jaw closes and cutter locking trigger joint;

Figure 43 C shows the side view of the clamp apparatus of Figure 43 A, and wherein cutter locking trigger is pressed and departs from cutter;

Figure 43 D shows the side view of the clamp apparatus of Figure 43 A, and wherein cutter is pushed into;

Figure 44 A shows the side partial view of the exemplary alternative cutter with energy-sensitive beam;

Figure 44 B shows the side partial view of the cutter shown in Figure 44 A, and wherein latching member is energized;

Figure 45 shows the side view of another exemplary alternative clamp apparatus with cutter locking feature structure;

Figure 46 shows the side partial view of the cutter locking feature structure of Figure 45, and wherein cutter locking trigger departs from;

Figure 47 A shows the side view of the exemplary alternative clamp apparatus with bending cutter pushing ram;

Figure 47 B shows the side view of the clamp apparatus of Figure 47 A, and wherein bending cutter pushing ram is pushed into;

Figure 48 shows the side view of the exemplary alternative clamp apparatus with spring-loaded cutter locking feature structure;

Figure 49 A shows the perspective view of the spring-loaded cutter locking feature structure of Figure 48, described cutter locking feature structural engagement cutter;

Figure 49 B shows the perspective view of the spring-loaded cutter locking feature structure of Figure 48, and described cutter locking feature structure departs from and wherein cutter is pushed into;

Figure 50 shows the side sectional view of the exemplary alternative clamp apparatus with the cutter that motor drives;

Figure 51 A shows the side sectional view of the exemplary alternative clamp apparatus with ratchet pad;

Figure 51 B shows the side sectional view of the clamp apparatus of Figure 51 A, and wherein ratchet pad closes;

Figure 52 shows the enlarged side view of the energising feature structure of the closed triggering using slip ring;

Figure 53 A shows the side view of the exemplary alternative clamp apparatus of the energising feature structure of the closed triggering near the jaw that has and be positioned at clamp apparatus; With

Figure 53 B shows the side view of the clamp apparatus of Figure 53 A, and wherein jaw closes and closes the energising feature structure triggered and is engaged.

Accompanying drawing not intended to be limit by any way, and expect that the various embodiments of this technology can be carried out in many other ways, comprise those modes of unnecessary description in the accompanying drawings.To be incorporated in this description and the accompanying drawing forming its part shows some aspects of this technology, and together with description for explaining the principle of this technology; But, should be appreciated that this technology is not limited to shown accurate arrangement.

Detailed description of the invention

The following description of some example of this technology shall not be applied to and limits its scope.Illustrated (being considered to for one of best mode implementing this technology) by following, other examples of this technology, feature, aspect, embodiment and advantage will become apparent for those skilled in the art.As should be appreciated, the techniques described herein comprise other different and obvious aspects, and these all do not depart from this technology.Therefore, the drawings and specific embodiments should be regarded as being in fact exemplary and nonrestrictive.

It is also understood that in instruction content as herein described, expression way, embodiment, example etc. any one or more can with as herein described other instruct in content, expression way, embodiment, example etc. any one or more combine.Therefore, following instruction content, expression way, embodiment, example etc. should not be considered as being isolated from each other.With reference to present teachings, can for the ordinary skill in the art will be apparent in order to the various suitable methods combining present teachings.This type of amendment and modification are intended to be included in the scope of claims.

i. exemplary clamp apparatus

Fig. 1 shows the exemplary clamp apparatus 10 that can operate with manipulating tissue.The pivot fitting 22 that apparatus 10 comprises the first shank 12, second shank 14 and they is linked together.Shank 12,14 can comprise the nylon of glass-filled and/or other suitable material any.Shank 12,14 is electrically isolated from one in this example, as will be described in more detail.Elastic ribbon 18 be positioned at pivot fitting 22 nearside and by shank 12,14 be flexibly biased to as shown in Figure 1 open configuration.Only by way of example, elastic ribbon 18 can comprise sheet spring.Certainly, other suitable components any can be used to make shank 12, and 14 are flexibly biased.Alternatively, shank 12,14 just may not have elastic biasing member.Apparatus 10 also comprises the first jaw 42 be communicated with the first shank 12 and the second jaw 44 be communicated with the second shank 14.Cable 20 is also communicated with the second shank 14, controller 30 and power source 32.Apparatus 10 also comprises the trigger button 16 be arranged on the second shank 14.

In general, apparatus 10 can operate with grasping tissue.Should be appreciated that grasping tissue can comprise to carry out grasping tissue by relatively little compression stress and carry out grasping tissue by moderate to severe compression stress.In addition, in some cases, should be appreciated that the mixing that can use compression stress.Such as, user may wish apply light compression stress to the some parts of tissue and apply heavier power to the other parts of tissue.In some cases, user may wish to handle (tractive, side push away) tissue.Manipulating tissue can comprise tractive or promote the tissue of clamping.In addition, user even may wish to use the outside that faces of the distal end of apparatus 10 to assign to make to organize move to passivity in surgical field as desired by a user.Apparatus 10 can also operate with by making tissue be energized to organizing transmission bipolarity radio-frequency (RF) energy, and this causes tissue welding or is sealed.Although bipolarity radio-frequency (RF) energy is sent by apparatus 10 in this example, should be appreciated that other suitable form that tissue also can be used to be energized, with reference to instruction content herein, this will be apparent for the ordinary skill in the art.To it is also understood that before seal tissue, afterwards or simultaneously, apparatus 10 can be used to cut and organize.Particularly, the cut edge in apparatus 10 can be used cut the tissue clamping with apparatus 10 and seal.Or alternatively, apparatus 10 can use the actuating cutter or other blade that move to cut clamped tissue relative to apparatus 10 in addition.In some patterns, the other parts of apparatus 10 can against histokinesis to cut or to pull open tissue.Only by way of example, jaw 42,44 itself can operate with simply by by enough power by shank 12,14 toward each other extruding cut and organize.

Shank 12,14 can operate to be clamped by user and press together in scissor grip part mode.Although exemplary pattern shows shank 12,14 have scissor grip part configuration, should be appreciated that the grip part of other type also can be used for shank 12,14.Such as, shank 12,14 can have pistol type grip part or other suitable configuration any, and described other suitable configuration any can operate to make user can manually activate shank 12, and 14 carry out closed jaw 42,44; And make user can be held in jaw 42 at tissue holder, control instrument 10 after between 44.Jaw 42,44 have bending configuration in this example, but are to be understood that, jaw 42,44 can have and can operate to clamp any suitable configuration with manipulating tissue, and with reference to instruction content herein, this will be apparent for the ordinary skill in the art.Such as, in some patterns, jaw 42,44 can have straight configuration.

Pivot fitting 22 can operate to make jaw 42, and 44 can activate shank 12 in response to user, and 14 and open and close.Be to be understood that, pivot fitting 22 can comprise and can operate to make jaw 42, and 44 can activate shank 12 in response to user, and 14 and closed any suitable linkers or mechanism, with reference to instruction content herein, this will be apparent for the ordinary skill in the art.Elastic ribbon 18 to be positioned near pivot fitting 22 and to engage shank 12,14, makes shank 12, and 14 are biased to and remain in as seen open position in FIG.When apparatus 10 is in the make position shown in Fig. 2, elastic ribbon 18 is as finding is bending in fig. 2.When user release shank 12,14 or just unclamp him or she to shank 12, during the gripping of 14, elastic ribbon 18 pushes shank 12 open, and 14 get back to the state shown in Fig. 1 to make apparatus 10.

Trigger button 16 to be positioned on the second shank 14 and to be oriented to enough can grip near user the place of the second shank 14 further, make user can catch shank 12,14 and with grasping shank 12, the same hand of 14 activates trigger button 16, thus makes it possible to one-handed performance apparatus 10.Trigger button 16 can comprise the single promotion button as shown in exemplary pattern, but should be appreciated that trigger button 16 can comprise multiple button or one or more button with multiple actuation phase.

Cable 20 comprises the electric insulation cable be communicated with controller 30.Cable 20 is communicated with power source 32 further.Cable 20 comprises any suitable structure that can operate with jaw 42,44 delivery of energy to apparatus 10.Particularly, cable 20 at least comprises two wires being positioned at cable 20, and make described wire can operate with to jaw 42,44 send bipolarity energy.One or more wire can be communicated with the first jaw 42, makes the first jaw 42 serve as positive wire, and another extending through cable 20 is organized one or more wire and be communicated with to serve as negative wire with the second jaw 44.Therefore, when jaw 42,44 grip tissue and delivery of energy time, bipolarity energy is by being delivered to tissue through organized delivery to another jaw 44 from a jaw 42.Although cable 20 is connected to shank 14, should be appreciated that cable 20 can be communicated with apparatus 10 at any desired part place of apparatus 10.

Controller 30 and power source 32 can operate with by cable 20 to apparatus 10 delivery of energy.Particularly, controller 30 can comprise circuit, processor, memorizer and/or can operate to start, stop or otherwise controlling other suitable parts any of power source 32.Power source 32 can operate with by cable 20 to jaw 42,44 send bipolarity energy.

Fig. 3 shows the exploded view of apparatus 10 substantially to illustrate how energy is transferred to wire 20 from power source 32 and controller 30, is then transferred to jaw 42,44.Particularly, cable 20 is divided into the first wire 46 and the second wire 48.First wire 46 connects with trigger switch 17, and described switch is by activating trigger button 16 optionally open and close.Certainly, how optionally trigger button 16 is only one of open and close circuit only illustrative example.Other suitable feature structure any can be used.Trigger switch 17 is resiliently biased to open position, makes user must promote trigger button 16 and carrys out closure trigger switch 17; And trigger switch 17 will be opened again when then user discharges trigger button 16.Trigger switch 17 also connects with privates 47, and described privates directly connects with jaw 44.In some patterns, trigger switch 17 moves to shank 12, and the proximal region of 14 and trigger button 16 are omitted.This type of nearside trigger switch 17 can be positioned on shank 12, and between the surface of 14, described surface is facing with each other and at shank 12, and 14 move towards one another when pressing together.Only by way of example, trigger switch 17 can comprise elastic sheet switch, and described elastic sheet switch only has when shank 12, and 14 is just closed when pressing together completely, is fully clamped in jaw 42, between 44 to indicate to organize before can applying radio-frequency (RF) energy to tissue.With reference to instruction content herein, other suitable positions of trigger switch 17 and modification will be apparent for the ordinary skill in the art.

Second wire 48 directly connects with elastic ribbon 18, described elastic ribbon be conduction and connect to provide with jaw 42 power path passing to jaw further.Should be appreciated that elastic ribbon 18 does not contact any conductive region of shank 14 or jaw 44.Although elastic ribbon 18 itself provides power path in this example, should be appreciated that elastic ribbon 18 alternatively only can provide the mechanical support to some other cables.Such as, wire is attachable to the proximal side of elastic ribbon 18.

Apparatus 10 also comprises felt pad 50 and insulating washer 52.Felt pad 50 and insulating washer 52 can operate to make electric insulation in the part of the first wire 46 and associated components and the second wire 48 and associated components these type of positive pole parts and the close especially apparatus 10 of anode member wherein, thus prevent positive pole parts and anode member short circuit.In addition, as finding in the diagram, should be appreciated that shank 12, the part of 14 is made up of insulating exterior 54, and make when wire 46,48 runs through apparatus 10, wire 46,48 do not form short circuit.Insulating exterior 54, insulating washer 52 and/or any other dielectric features structure can be used to make shank 12, and 14 is insulated from each other.Should be appreciated that jaw 42,44 must against clamp tissue, and trigger button 16 must activate so that closed circuit.After closed circuit, provide bipolarity radio-frequency (RF) energy to tissue.

Jaw 42,44 can see in cross section in Figure 5.Jaw 42,44 limit clamping region between which, and described clamping region has stairstepping profile that is asymmetric, that stretch out, make jaw 42 complementary with jaw 44.Particularly, jaw 42 comprises the region 60 of the first general planar, the transitional region 62 tilted and the region 64 of the second general planar.Jaw 44 comprises the region 70 of the first general planar, the transitional region 72 tilted and the region 74 of the second general planar.Transitional region 62,72 have identical width (w separately ₁) and height (h ₁).Region 60,70 can be complimentary to one another, region 62, and 72 can be complimentary to one another, and region 64,74 can be complimentary to one another.Region 60,62,64 therefore at jaw 42,44 closed together time and corresponding region 70,72,74 is nested.Should be appreciated that jaw 42,44 can cross over all regions 60,62,64,70,72,74 contact tissues.According to user to shank 12, the size of 14 power applied, this contact may be grip tissue or cut and organize.

In this example, region 64,70 are conduction and apply radio-frequency (RF) energy to tissue, and region 60,62,72,74 provides non-conductive tissue contacting surface.Such as, region 60,62,72,74 can scribble electrically insulating material, and region 64,70 presents the conductive material (such as, the metal of exposure) of exposure.Region 64,70 therefore can serve as discrete, bipolar electrode is surperficial.Although jaw 42,44 are formed by conductive material in this example substantially, region 60,62,72, and 74 comprise electric insulation coating layer.Should be appreciated that this configuration can provide when jaw 42,44 closed time biased and biased transverse to each other vertically each other electrode surface.It is also understood that this configuration can provide along in vertical dimensions and transverse dimensions relative to jaw 42, the radio-frequency (RF) energy transmission in the path that the longitudinal axis of 44 tilts, wherein said path is in substantially parallel relationship to region 62,72.In other words, the actual tissue regions receiving bipolarity radio-frequency (RF) energy will only be contact area 62, and 72 and be positioned at region 62, the tissue between 72.Therefore, tissue will not cross over jaw 42, the whole transverse width received RF energy of 44.Therefore this configuration can make the thermal diffusion by applying the heat that bipolarity radio-frequency (RF) energy causes to tissue minimize.This type of thermal diffusion minimizes and then can make to wish that the possible collateral damage of the tissue in the particular organization region of welding/sealing/condensation and/or cutting minimizes to contiguous surgeon.

In some other patterns, region 60,62,72,74 are conduction and apply radio-frequency (RF) energy to tissue, and region 64,70 provides non-conductive tissue contacting surface.In other other patterns, region 62,64,70,72 are conduction and apply radio-frequency (RF) energy to tissue, and region 60,74 provides non-conductive tissue contacting surface.In other other patterns, region 60,72 are conduction and apply radio-frequency (RF) energy to tissue, and region 62,64,70,72 provides non-conductive tissue contacting surface.Alternatively, all regions 60,62,64,70,72,74 can be conduction and to tissue apply radio-frequency (RF) energy.In aforementioned arbitrary example, a jaw 42 can be associated with the first polarity, and another jaw 44 can be associated with the second polarity, to apply bipolarity radio-frequency (RF) energy to tissue.

As seen in Figure 4, the jaw 42,44 of this example also comprises and is positioned at region 60,62,64,70,72, the recess 80 of one group of horizontal orientation in 74.Should be appreciated that recess 80 is only optional.It is also understood that jaw 42,44 can have various alternate feature structure and configuration.Several only illustrative example of this type of alternate feature structure and configuration will be described in more detail below, but with reference to instruction content herein, other example will be apparent for the ordinary skill in the art.

iI. exemplary alternative jaw feature structure

Fig. 6-29 shows jaw 42, the various examples of 44 alternate forms that can take.Should be appreciated that the various examples of the following stated can be easy to be incorporated in apparatus 10 and can to apply bipolarity radio-frequency (RF) energy to tissue.Fig. 6 particularly illustrates the exemplary jaw 142 of the groove 150 with longitudinal extension.Groove 150 extends longitudinally through the center of jaw 142 in this example.Plug-in unit 152 is received in jaw 142 in the mode that can slide by making plug-in unit 152 slip in groove 150.Fig. 7 shows the jaw 142 with the plug-in unit 152 be positioned in groove 150.Upper jaw 144 also comprises the groove 151 of the groove being similar to lower jaw 142.Second plug-in unit 154 can fit in groove 151.Be placed on groove 150, the plug-in unit 152,154 in 151 is formed and is orientated to and makes to be clamped in plug-in unit 152, and the tissue 160 between 154 is compressed as shown in Figure 7 obliquely.Plug-in unit 152,154 in this example with jaw 142,144 formed dovetails coordinate and can from jaw 142, jaw 142 is slipped into, in 144 in the back side of 144.Certainly, other suitable alternate forms any of dovetail configuration can be used; If and/or need, plug-in unit 152,154 can from jaw 142, and the distal end of 144 slips into.

The plug-in unit 152,154 of this example is formed by electrically insulating material, and jaw 142,144 is formed by conductive material.Only by way of example, plug-in unit 152,154 can be formed by Surgical Grade plastics and/or positive temperature coefficient (PTC) critesistor polymer etc.Plug-in unit 152 wherein, 154 comprise in the pattern of PTC thermistor polymer, should be appreciated that plug-in unit 152, and 154 can at plug-in unit 152, and the temperature of 154 is lower than during a certain threshold value being conduction; And plug-in unit 152,154 can at plug-in unit 152, the temperature of 154 is higher than during a certain threshold value being electric insulation.With reference to instruction content herein, other material that can be used for being formed plug-in unit 152,154 will be apparent for the ordinary skill in the art.Only by way of example, jaw 142,144 can be formed by the titanium of anodic oxidation or coated with conductive material (such as diamond-like-carbon (DLC), 5 grades of titaniums and/or certain other material) or aluminum.With reference to instruction content herein, other material that can be used for being formed jaw 142,144 will be apparent for the ordinary skill in the art.

In this example, plug-in unit 152,154 fit in jaw 142, in 144, an only part for each jaw 142,144 are covered by corresponding plug-in unit 152,154.By plug-in unit 152, the tissue contact region of 154 jaws 142,144 exposed will serve as electrode surface, and make jaw 142, the exposed surface of 144 can operate to send bipolarity radio-frequency (RF) energy to tissue 160.This type of of radio-frequency (RF) energy is sent and effectively can be welded/seal/coagulating tissue 160 as mentioned above, and can contribute to according to user by by shank 12,14 extruding and to jaw 142, the size of 144 power applied cuts off tissue 160 toward each other.

In exemplary use, user is first by plug-in unit 152, and 154 put into groove 150, in 151.In some cases, jaw 142,144 must (such as, being separated completely at places such as pivot fittings 22) completely separate from each other to make plug-in unit 152,154 slip into groove 150, in 151.In this type of pattern, jaw 142,144 at plug-in unit 152,154 insertion grooves 150, is linked together (such as, at pivot fitting 22 place) after in 151; And jaw 142, the connection of 144 prevents plug-in unit 152, skids off jaw 142 during use, 144 after 154.In addition or alternatively, snap in features structure, interference fit, fixture and/or further feature structure/technology can be used plug-in unit 152,154 fix relative to its corresponding jaw 142,144.Once jaw 142,144 and plug-in unit 152,154 fit together, user just can extrude shank 12, and 14 will have plug-in unit 152, and the jaw 142,144 of 154 clamps against tissue 160.Then pass through by plug-in unit 152, the tissue contacting surface of 154 jaws 142,144 exposed sends radio-frequency (RF) energy to tissue 160, thus welding/sealing/coagulating tissue 160.Then user can extrude shank 12,14 further, and to organize 160 the most at last along plug-in unit 152,154 gathering parts tighten the point to cutting and organizing 160.

Fig. 8-9 shows and can fit in jaw 242, the groove 250 of 244, the exemplary alternative plug-in unit 252,254 in 251.In this example, plug-in unit 252,254 can insert jaw 242 by the front of jaw 242,244, in 244, but should be appreciated that jaw 242, and 244 can alternatively from jaw 242, and the proximal end of 244 receives plug-in unit 252,254.Fig. 9 shows and is positioned at jaw 242, the plug-in unit 252,254 in 244.Plug-in unit 252,254 and jaw 242,244 are substantially identical with jaw 142,144 with above-mentioned plug-in unit 152,154, and the complementary characteristic structure unlike groove 251 and plug-in unit 152,154 has spherical shape in this example instead of has swallow-tail form profile.Certainly, other suitable handing-over configuration any can be used.

Figure 10 A-10C show can operate to clamp, weld/seal/condense and cut and organize 360 another group exemplary alternative plug-in unit 352,354 and jaw 342,344.The plug-in unit 352,354 of this example is welded to jaw 342,344, but should be appreciated that plug-in unit 352, and 354 can alternatively use any suitable feature structure and/or technology to be fixed to jaw 342,344.Equally, the plug-in unit 352 of this example, 354 are formed by electrically insulating material; And jaw 342,344 is formed by conductive material.Plug-in unit 352,354 comprise along plug-in unit 352, the convex ridge 356,358 that the longitudinal length of 354 extends.Figure 10 A shows jaw 342, and 344 are pushed to wherein jaw 342,344 toward each other only clamps the point of tissue 360.Figure 10 B shows jaw 342, and 344 along with jaw 342, and 344 are energized by radio-frequency (RF) energy and are pushed to the point of wherein jaw 342,344 welding/sealing/coagulating tissue 360 further toward each other.Figure 10 C shows jaw 342, and 344 are pushed to wherein convex ridge 356,358 further toward each other cuts off the point of tissue 360.

Should be appreciated that convex ridge 356, the configuration of 358 contributes to making by jaw 342,344 and plug-in unit 352,354 applied pressure along by convex ridge 356, the 358 contact tissue lines set up are concentrated.This pressure is concentrated and can be conducive to cutting off tissue 360, and does not need user at shank 12, and 14 places apply significant power.In this example, convex ridge 356,358 have rounding profile substantially, but should be appreciated that convex ridge 356, and 358 alternatively can have the profile for square, triangle, other suitable configuration pointed or any.

Figure 11 A-11C show can operate to clamp, weld/seal/condense and cut and organize 460 another group exemplary alternative plug-in unit 452,454 and jaw 442,444.The plug-in unit 452,454 of this example fits in jaw 442, and the shallow slot 450 of 444 in 451, but should be appreciated that plug-in unit 452, and 454 can alternatively use any suitable feature structure and/or technology to be fixed to jaw 442,444.Plug-in unit 452,454 comprise along plug-in unit 452, the protuberance 456,458 that the longitudinal length of 454 extends.Figure 11 A shows jaw 442, and 444 are pushed to wherein jaw 442,444 toward each other only clamps the point of tissue 460.Figure 11 B shows jaw 442, and 444 along with jaw 442, and 444 are energized by radio-frequency (RF) energy and are pushed to the point of wherein jaw 442,444 welding/sealing/coagulating tissue 460 further toward each other.Figure 11 C shows jaw 442, and 444 are pushed to wherein convex ridge 456,458 further toward each other cuts off the point of tissue 460.The pressure being applied to tissue 460 can be concentrated substantially in convex peak 456,458, makes convex peak 456,458 can be regarded as the substitute of above-mentioned convex ridge 356,358.

Figure 12-13 show can operate to clamp, weld/seal/condense and cut and organize 560 another group exemplary alternative plug-in unit 552,554 and jaw 542,544.The plug-in unit 552,554 of this example fits in jaw 542 in the mode that can slide, and the corresponding "T"-shaped groove 550 of 544, in 551.Plug-in unit 552 comprises plastic electrical insulation part 553 and positive temperature coefficient (PTC) critesistor polymer moieties 556.PTC thermistor polymer moieties 556 limits raised brim 557.Plug-in unit 554 comprises plastic electrical insulation part 555 and PTC thermistor polymer moieties 558.PTC thermistor polymer moieties 558 limits raised brim 559.As visible in fig. 13, PTC thermistor polymer moieties 556,558 partly extends to the corresponding "T"-shaped groove 550 of contiguous plastic electrical insulation part 553,555, in 551.

Should be appreciated that PTC thermistor polymer moieties 556,558 can the temperature of PTC thermistor polymer moieties 556,558 lower than during a certain threshold value be conduction; And PTC thermistor polymer moieties 556,558 can in the temperature of PTC thermistor polymer moieties 556,558 higher than during a certain threshold value being electric insulation.Therefore, when the temperature of PTC thermistor polymer moieties 556,558 is lower than a certain threshold value and when applying radio-frequency (RF) energy to jaw, radio-frequency (RF) energy can flow through tissue 560 from PTC thermistor polymer moieties 556 to PTC thermistor polymer moieties 558.Should be appreciated that this radio-frequency (RF) energy flow path through tissue 560 is what tilt, be similar to above for jaw 42, the inclination radio-frequency (RF) energy path described in 45.Radio-frequency (RF) energy also can flow through tissue 560, still along slant path lower than during described threshold value from the tissue contacting surface of jaw 542 to the tissue contacting surface of jaw 542 in the temperature of PTC thermistor polymer moieties 556,558.Once the temperature of PTC thermistor polymer moieties 556,558 exceedes described threshold value, PTC thermistor polymer moieties 556,558 become electric insulation.In that stage, flow through with regard to tissue 560 completely with regard to radio-frequency (RF) energy continuation, the tissue contacting surface of radio-frequency (RF) energy just from the tissue contacting surface of jaw 542 to jaw 542 flows through tissue 560.In some other patterns, each the whole of plug-in unit 552,554 are made up of ambroin, make not use PTC thermistor polymer.In this type of pattern, radio-frequency (RF) energy the same tissue contacting surface along slant path from jaw 542 can flow through tissue 560 to the tissue contacting surface of jaw 542 simply.

It is also understood that raised brim 557,559 can serve as pressure concentrates feature structure, thus makes by jaw 542,544 and plug-in unit 552,554 applied pressure along by raised brim 557, the 559 contact tissue lines set up are concentrated.This pressure is concentrated and can be conducive to cutting off tissue 560, and does not need user at shank 12, and 14 places apply significant power.Raised brim 557, therefore 559 be similar to above-mentioned convex ridge 356,358 and convex peak 456,458, but the raised brim 557,559 of this example presents than convex ridge 356, and 358 and substantially sharper edge, convex peak 456,458.But in this example, raised brim 557,559 is sharp not and can not cut and organize 560 when there is not the remarkable pressure being applied to tissue 560.

Certainly, raised brim 557,559 are only optional.Such as, Figure 14-15 shows one group of exemplary alternative plug-in unit 652,654 and jaw 642,644, and described plug-in unit and jaw are similar to plug-in unit 552, and 554 and jaw 542,544; And can operate to clamp, weld/seal/condense and cut and organize.The plug-in unit 652,654 of this example fits in jaw 642 in the mode that can slide, and the corresponding "T"-shaped groove 650 of 644, in 651.Plug-in unit 652 comprises plastic electrical insulation part 653 and positive temperature coefficient (PTC) critesistor polymer moieties 656.The pressure that the PTC thermistor polymer moieties 656 of this example does not limit raised brim or other type concentrates feature structure.Plug-in unit 654 comprises plastic electrical insulation part 655 and PTC thermistor polymer moieties 658.The pressure that PTC thermistor polymer moieties 658 does not limit raised brim or other type yet concentrates feature structure.As visible in fig .15, PTC thermistor polymer moieties 656,658 partly extends to the corresponding "T"-shaped groove 650 of contiguous plastic electrical insulation part 653,655, in 651.

Should be appreciated that PTC thermistor polymer moieties 656,658 can the temperature of PTC thermistor polymer moieties 656,658 lower than during a certain threshold value be conduction; And PTC thermistor polymer moieties 656,658 can in the temperature of PTC thermistor polymer moieties 656,658 higher than during a certain threshold value being electric insulation.Therefore, when the temperature of PTC thermistor polymer moieties 656,658 is lower than a certain threshold value and when applying radio-frequency (RF) energy to jaw, radio-frequency (RF) energy can flow through tissue from PTC thermistor polymer moieties 656 to PTC thermistor polymer moieties 658.Should be appreciated that this radio-frequency (RF) energy flow path through tissue is what tilt, be similar to above relative to jaw 42, the inclination radio-frequency (RF) energy path described in 45.Radio-frequency (RF) energy also can flow through tissue lower than during described threshold value from the tissue contacting surface of jaw 642 to the tissue contacting surface of jaw 642 in the temperature of PTC thermistor polymer moieties 656,658, remains along slant path.Once the temperature of PTC thermistor polymer moieties 656,658 exceedes described threshold value, PTC thermistor polymer moieties 656,658 become electric insulation.In that stage, flow through completely with regard to tissue with regard to radio-frequency (RF) energy continuation, radio-frequency (RF) energy only flows through tissue from the tissue contacting surface of jaw 642 to the tissue contacting surface of jaw 642.In some other patterns, each the whole of plug-in unit 652,654 are made up of ambroin, make not use PTC thermistor polymer.In this type of pattern, radio-frequency (RF) energy the tissue contacting surface only from the tissue contacting surface of jaw 642 to jaw 642 can flow through tissue, equally along slant path.

It is also understood that jaw 642,644 and plug-in unit 652,654 still can operate to cut and organize when there is not feature structure in raised brim or other set of organizations.Such as, jaw 642,644 and plug-in unit 652,654 can by enough power by shank 12,14 cut off when pressing together and are captured in jaw 642,644 and plug-in unit 652, the tissue between 654.In some cases, this class loading may be easier to be cut-off after applying radio-frequency (RF) energy to tissue.Only by way of example, first user can use jaw 642,644 and plug-in unit 652,654 partly clamp organizationally, apply radio-frequency (RF) energy certain hour section, then use jaw 642 to tissue, 644 and plug-in unit 652,654 further clamping organizationally to cut off tissue.With reference to instruction content herein, other suitable feature structure and using method will be apparent for those of ordinary skill in the art.

iII. there is the exemplary jaw movably organizing Cutting feature structure

In some cases, alternative Cutting feature structure (such as can moving knife) can be used to cut off tissue, instead of use by jaw 42, the clamping pressure of the modification of 44 cuts off tissue.Figure 16-17 shows has plug-in unit 752, and 754 and the exemplary pattern of jaw 742,744 of I ellbeam cutter 770.The plug-in unit 752,754 of this example is substantially similar to above-mentioned plug-in unit 652,654, and the plug-in unit 752,754 unlike this example limits "T"-shaped groove 757,759 separately.Plug-in unit 752 comprises plastic electrical insulation part 753 and positive temperature coefficient (PTC) critesistor polymer moieties 756.Plug-in unit 754 comprises plastic electrical insulation part 755 and PTC thermistor polymer moieties 758.PTC thermistor polymer moieties 756,758 partly extends to the corresponding "T"-shaped groove 750 of the jaw 742,744 of contiguous plastic electrical insulation part 753,755, in 751.

Should be appreciated that PTC thermistor polymer moieties 756,758 can the temperature of PTC thermistor polymer moieties 756,758 lower than during a certain threshold value be conduction; And PTC thermistor polymer moieties 756,758 can in the temperature of PTC thermistor polymer moieties 756,758 higher than during a certain threshold value being electric insulation.Therefore, when the temperature of PTC thermistor polymer moieties 756,758 is lower than a certain threshold value and when applying radio-frequency (RF) energy to jaw, radio-frequency (RF) energy can flow through tissue 760 from PTC thermistor polymer moieties 756 to PTC thermistor polymer moieties 758.Should be appreciated that this radio-frequency (RF) energy flow path through tissue 760 is what tilt, be similar to above for jaw 42, the inclination radio-frequency (RF) energy path described in 45.Radio-frequency (RF) energy also can flow through tissue 760 lower than during described threshold value from the tissue contacting surface of jaw 742 to the tissue contacting surface of jaw 742 in the temperature of PTC thermistor polymer moieties 756,758, remains along slant path.Once the temperature of PTC thermistor polymer moieties 756,758 exceedes described threshold value, PTC thermistor polymer moieties 756,758 become electric insulation.In that stage, flow through completely with regard to tissue 760 with regard to radio-frequency (RF) energy continuation, radio-frequency (RF) energy only flows through tissue 760 from the tissue contacting surface of jaw 742 to the tissue contacting surface of jaw 742.In some other patterns, each the whole of plug-in unit 752,754 are made up of ambroin, make not use PTC thermistor polymer.In this type of pattern, can be the same tissue contacting surface along slant path from jaw 742 flow through tissue to the tissue contacting surface of jaw 742 to radio-frequency (RF) energy.

The I ellbeam cutter 770 of this example comprises a pair upper transverse bolt 772 outwardly and a pair lower transverse bolt 774 outwardly.In some other patterns, pin 772,774 are replaced by lateral flange and/or some other structures.Pin 772, the vertical dimension between 774 is fixing in this example.I ellbeam cutter 770 also comprises the sharp cut edge 776 extended vertically.I ellbeam cutter 770 can operate with longitudinal translation through jaw 742,744, the page that described jaw will enter and exit in the view shown in Figure 16-17.Pin 772 is arranged in the top of "T"-shaped groove 759 of plug-in unit 754; And pin 774 is arranged in the bottom of "T"-shaped groove 757 of plug-in unit 752.

In use, jaw 742,744 can close at compress tissue 760 on tissue 760, then welding/sealing/coagulating tissue 760 as mentioned above.Then, can distally drive I ellbeam cutter 770 to cut and organize 760 as shown in figure 17.Below how more detailed description distally can be driven several only illustrative example of I ellbeam cutter 770; And with reference to instruction content herein, other examples will be apparent for the ordinary skill in the art.When the jaw when distally driving I ellbeam cutter 770 742,744 incomplete compress tissue 760, pin 772,774 can serve as against plug-in unit 752, the cam of 754, thus by jaw 742,744 are driven into complete compression position.

In some patterns, I ellbeam cutter 770 be conduction and provide radio-frequency current from jaw 742, one or two the return path in 744.Therefore, if when I ellbeam cutter 770 adjacent tissue (such as, the distally of I ellbeam cutter 770 advance during and/or afterwards) apply radio-frequency (RF) energy, then radio-frequency (RF) energy can flow through tissue 760 from the tissue contacting surface of jaw 742 to I ellbeam cutter 770; And/or flow through tissue 760 from the tissue contacting surface of jaw 744 to I ellbeam cutter 770.In this type of operational phase, PTC thermistor polymer moieties 756,758 can be heated to electric insulating state, makes PTC thermistor polymer moieties 756,758 not serve as I ellbeam cutter 770 and jaw 742, the short circuit paths between 744.Alternatively, I ellbeam cutter 770 can be insulation or can in addition radio-frequency (RF) energy transmission in do not play any effect.Such as, in some cases, I ellbeam cutter 770 is driven across the stage of tissue 760 wherein, does not apply any radio-frequency (RF) energy by jaw 742,744 or I ellbeam cutter 770.

Figure 18-19 shows the I ellbeam cutter 770 combined with a pair exemplary alternative jaw 842,844.The jaw 842,844 of this example has corresponding plastic electrical insulation part 852,854, corresponding positive temperature coefficient (PTC) critesistor polymer moieties 856,858 and corresponding electrode strips 862,864.Insulated part 852,854 are arranged in through jaw 842, on the opposite side of the vertical plane at the center of 844.PTC thermistor part 856,858 is also arranged in through jaw 842, on the opposite side of the vertical plane at the center of 844.Electrode strips 862 is fixed to the top of insulated part 852; And electrode strips 864 is fixed to the top of insulated part 854.Only by way of example, electrode strips 862,864 can hot riveting, pin connect, gummed, coated molded or be otherwise fixed to corresponding insulated part 852,854.Insulated part 852,854 also can hot riveting, pin connect, gummed, coated molded or be otherwise fixed to corresponding jaw 842,844.Equally, PTC thermistor part 856,858 can hot riveting, pin connect, gummed, coated molded or be otherwise fixed to corresponding jaw 842,844.With reference to instruction content herein, can will be apparent in order to other suitable methods that above-mentioned parts are fixed together for the ordinary skill in the art.

Although Figure 18 illustrate only the flexible wire pipe 863 for providing power to electrode strips 862, should be appreciated that similar conduit can connect with electrode strips 864.It is also understood that this type of conduit 863 can connect with above-mentioned wire 46,48, activate with the actuating in response to trigger button 16, etc.

Should be appreciated that PTC thermistor polymer moieties 856,858 can the temperature of PTC thermistor polymer moieties 856,858 lower than during a certain threshold value be conduction; And PTC thermistor polymer moieties 856,858 can in the temperature of PTC thermistor polymer moieties 856,858 higher than during a certain threshold value being electric insulation.Therefore, when PTC thermistor polymer moieties 856, the temperature of 858 is lower than a certain threshold value and when applying radio-frequency (RF) energy to jaw, radio-frequency (RF) energy can flow through from PTC thermistor polymer moieties 856 to PTC thermistor polymer moieties 858 and organize (not shown).Should be appreciated that this radio-frequency (RF) energy flow path through tissue is what tilt, be similar to above for jaw 42, the inclination radio-frequency (RF) energy path described in 45.Radio-frequency (RF) energy also can flow through tissue from electrode strips 862 to electrode strips 864, and this is another slant path.In addition, radio-frequency (RF) energy also can flow through tissue from electrode strips 862 to PTC thermistor polymer moieties 858; And flow through tissue from electrode strips 864 to PTC thermistor polymer moieties 856.Therefore, should be appreciated that radio-frequency (RF) energy can flow through tissue when PTC thermistor polymer moieties 856,858 is in conduction state along four different paths.

Once the temperature of PTC thermistor polymer moieties 856,858 exceedes described threshold value, PTC thermistor polymer moieties 856,858 become electric insulation.In that stage, flow through completely with regard to tissue with regard to radio-frequency (RF) energy continuation, radio-frequency (RF) energy only flows through tissue from electrode strips 862 to electrode strips 864.In some other patterns, PTC thermistor polymer moieties 856,858 are replaced by ambroin.In this type of pattern, radio-frequency (RF) energy can be flow through tissue from electrode strips 862 to electrode strips 864 along slant path equally.As another only illustrative example, electrode strips 862,864 can be omitted and radio-frequency (RF) energy can flow through tissue from PTC thermistor polymer moieties 856 to PTC thermistor polymer moieties 858, until temperature exceedes the threshold value that radio-frequency (RF) energy stops flowing through the some place of tissue.

As mentioned above, the I ellbeam cutter 770 of this example comprises a pair upper transverse bolt 772 outwardly and a pair lower transverse bolt 774 outwardly.Pin 772 is arranged in the groove 871 be defined in jaw 844; And pin 774 is arranged in the groove 870 be defined in jaw 842.I ellbeam cutter 770 can operate with longitudinal translation through jaw 842,844, the page that described jaw will enter and exit in the view shown in Figure 19.In use, jaw 842,844 can close organizationally with compress tissue, then welding/sealing as mentioned above/coagulating tissue.Then, can distally drive I ellbeam cutter 770 to cut and organize.Equally, below how more detailed description distally can be driven several only illustrative example of I ellbeam cutter 770; And with reference to instruction content herein, other examples will be apparent for the ordinary skill in the art.When distally driving I ellbeam cutter 770 when jaw 842,844 incomplete compress tissue, pin 772,774 can serve as against jaw 842, the cam of 844, thus by jaw 842,844 are driven into complete compression position.

iV. there is the exemplary jaw of outside organization's seal feature structure

The exemplary variation of above-mentioned jaw 42,44 can operate to weld/seal/and condensing is captured in jaw 42, the tissue between 44.In some cases, welding/sealing/condensation may be needed not to be captured in jaw 42, the tissue between 44.Such as, using after the jaw 42,44 of a certain pattern cuts off tissue, using I ellbeam cutter 770 to after cutting off tissue, and/or using further feature structure to cut off or otherwise after manipulating tissue, the tissue part of Continuous hemorrhage can be there is.Therefore, may need jaw 42, one or two the outside in 44 is pressed in this type of bleeding tissue part, to apply bipolarity radio-frequency (RF) energy to seal/coagulating tissue, and without the need to bleeding tissue part being clamped in jaw 42, between 44.Figure 20-22 shows the only exemplary modification of the jaw 42,44 with the outside that can operate to apply bipolarity radio-frequency (RF) energy to tissue.Below will be described in more detail these examples, but with reference to instruction content herein, other examples will be apparent for those of ordinary skill in the art.

Figure 20 shows a pair jaw 942,944, and each free conductive material (such as, metal) of described jaw is formed and comprises the electric insulation coating layer 943 optionally applied separately.With reference to instruction content herein, the various suitable material that can be used for being formed insulating coating 943 will be apparent for the ordinary skill in the art.Upper jaw 944 comprises negative polarity portion 950 and positive polarity portion 960.Similarly, lower jaw 942 comprises negative polarity portion 970 and positive polarity portion 980.

Insulating coating 943 covers a part for negative polarity portion 950, but interior tissue contact surface 952 is exposed and outside face 954 is exposed.Insulating coating 943 also covers a part for positive polarity portion 960, exposes and outside face 954 is exposed to make interior tissue contact surface 952.Similarly, insulating coating 943 covers a part for negative polarity portion 970, exposes and outside face 974 is exposed to make interior tissue contact surface 972.And similarly, insulating coating 943 covers a part for positive polarity portion 980, expose to make interior tissue contact surface 982 and outside face 984 is exposed.According to above-mentioned, should be appreciated that surface 962,964,982,984 can operate the positive pole being provided for being carried out radio-frequency (RF) energy transmission by tissue; And surface 952,954,972,974 can operate to be provided for by organizing the negative pole carrying out radio-frequency (RF) energy transmission.In some other patterns, surface 952,954,962,964,972,974,982, one or more in 984 are covered by insulating coating 943.Only by way of example, surface 962,972 can be covered by insulating coating 943.

In this example, surface 952,962,972,982 can operate with by being clamped in jaw 942, and the tissue between 944 transmits radio-frequency (RF) energy, thus welding/sealing/coagulating tissue.Particularly, radio-frequency (RF) energy can from surface 962 to surface 972; And/or be transmitted through tissue from surface 982 to surface 952.As shown in figure 20, surface 962,972 in this example transverse to each other and be biased vertically, makes radio-frequency (RF) energy will advance through tissue to surface 972 along slant path from surface 962, is similar to above for jaw 42, the slant path described in 44.Similarly, surface 952,982 in this example also transverse to each other and be biased vertically, makes radio-frequency (RF) energy will advance through tissue from surface 982 to surface 952 along slant path.

The jaw 942,944 of this example also limits the groove 990 that can receive I ellbeam cutter 770 together.Therefore, at activated surface 952,962,972,982 to weld/sealing/coagulating tissue before, period or afterwards, I ellbeam cutter 770 can be used to cut off jaw 942, the tissue between 944.Should be appreciated that comprising I ellbeam cutter 770 is only optional.Only by way of example, jaw 942,944 can then comprise convex ridge, convex peak, sharp edges and/or can at jaw 942,944 make pressure concentrate organizationally to cut off other suitable characteristics structure any of tissue when fully clamping organizationally.

At use jaw 942,944 weld/seal/condensing is captured in jaw 942, before or after tissue between 944, perhaps by before or after being cut off tissue by the I ellbeam cutter 770 being distally driven across groove 790, user can make jaw 942,944 around its longitudinal axis rotated about ninety degrees and by jaw 942, and the outside of in 944 compresses organizationally with sealing/coagulating tissue.Such as, the outside of jaw 942 can compress organizationally with by surface 974 by user, and 984 are placed to contact tissue.Then positive polarity portion 970 and negative polarity portion 980 can be energized to apply bipolarity radio-frequency (RF) energy by surface 974,984 to tissue, thus surfacewise 974,984 contact tissue point between region welding/seal tissue.Similarly, the outside of jaw 944 can compress organizationally with by surface 954 by user, and 964 are placed to contact tissue.Then positive polarity portion 950 and negative polarity portion 960 can be energized to apply bipolarity radio-frequency (RF) energy by surface 954,964 to tissue, thus surfacewise 974,984 contact tissue point between regional seal/coagulating tissue.As other modification as herein described, should be appreciated that energy can be supplied via control piece 30 and power source 32 as shown in Figure 1.But can use other appropriate power source, with reference to instruction content herein, this will be apparent for those of ordinary skill in the art.It is also understood that and neither use surface 952,962 wherein, 972,982 weld/seal/coagulating tissue is not when using I ellbeam cutter 770 (or further feature structure) to cut off tissue yet, can use surface 954,964,974,984 seal/coagulating tissue.

Figure 21-22 shows another and organizes exemplary jaw 1042,1044, and described jaw can operate optionally to weld/seal/and condense jaw 1042, the tissue of the tissue between 1044 or sealing/condensation jaw 1042,1044 outside.The jaw 1042,1044 of this example is substantially similar to above-mentioned jaw 842,844, and the jaw 1042,1044 unlike this example comprises outer electrode band 1066,1068.The jaw 1042,1044 of this example has corresponding plastic electrical insulation part 1052,1054, corresponding positive temperature coefficient (PTC) critesistor polymer moieties 1056,1058 and corresponding internal electrode band 1062,1064.Insulated part 1052,1054 are arranged in through jaw 1042, on the opposite side of the vertical plane at the center of 1044.PTC thermistor part 1056,1058 is also arranged in through jaw 1042, on the opposite side of the vertical plane at the center of 1044.Internal electrode band 1062 is fixed to the top of insulated part 1052; And internal electrode band 1064 is fixed to the top of insulated part 1054.With reference to instruction content herein, can will be apparent in order to the various suitable methods that above-mentioned parts are fixed together for the ordinary skill in the art.

Should be appreciated that PTC thermistor polymer moieties 1056,1058 can the temperature of PTC thermistor polymer moieties 1056,1058 lower than during a certain threshold value be conduction; And PTC thermistor polymer moieties 1056,1058 can in the temperature of PTC thermistor polymer moieties 1056,1058 higher than during a certain threshold value being electric insulation.Therefore, when PTC thermistor polymer moieties 1056, the temperature of 1058 is lower than a certain threshold value and when applying radio-frequency (RF) energy to jaw, radio-frequency (RF) energy can flow through from PTC thermistor polymer moieties 1056 to PTC thermistor polymer moieties 1058 and organize (not shown).Should be appreciated that this radio-frequency (RF) energy flow path through tissue is what tilt, be similar to above for jaw 42, the inclination radio-frequency (RF) energy path described in 45.Radio-frequency (RF) energy also can flow through tissue from electrode strips 1062 to electrode strips 1064, and this is another slant path.In addition, radio-frequency (RF) energy also can flow through tissue from electrode strips 1062 to PTC thermistor polymer moieties 1058; And flow through tissue from electrode strips 1064 to PTC thermistor polymer moieties 1056.Therefore, should be appreciated that radio-frequency (RF) energy can flow through tissue when PTC thermistor polymer moieties 1056,1058 is in conduction state along four different paths.

Once the temperature of PTC thermistor polymer moieties 1056,1058 exceedes described threshold value, PTC thermistor polymer moieties 1056,1058 become electric insulation.In that stage, flow through completely with regard to tissue with regard to radio-frequency (RF) energy continuation, radio-frequency (RF) energy only flows through tissue from electrode strips 1062 to electrode strips 1064.In some other patterns, PTC thermistor polymer moieties 1056,1058 are replaced by ambroin.In this type of pattern, radio-frequency (RF) energy can be flow through tissue from electrode strips 1062 to electrode strips 1064 along slant path equally.As another only illustrative example, electrode strips 1062,1064 can be omitted and radio-frequency (RF) energy can flow through tissue from PTC thermistor polymer moieties 1056 to PTC thermistor polymer moieties 1058, until temperature exceedes the threshold value that radio-frequency (RF) energy stops flowing through tissue.

As mentioned above, the I ellbeam cutter 770 of this example comprises a pair upper transverse bolt 772 outwardly and a pair lower transverse bolt 774 outwardly.Pin 772 is arranged in the groove 1071 be defined in jaw 1044; And pin 774 is arranged in the groove 1070 be defined in jaw 1042.I ellbeam cutter 770 can operate with longitudinal translation through jaw 1042,1044.In use, jaw 1042,1044 can close organizationally with compress tissue, then welding/sealing as mentioned above/coagulating tissue.Then, can distally drive I ellbeam cutter 770 to cut and organize.Equally, below how more detailed description distally can be driven several only illustrative example of I ellbeam cutter 770; And with reference to instruction content herein, other examples will be apparent for the ordinary skill in the art.When distally driving I ellbeam cutter 770 when jaw 1042,1044 incomplete compress tissue, pin 772,774 can serve as against jaw 1042, the cam of 1044, thus by jaw 1042,1044 are driven into complete compression position.

At use jaw 1042,1044 weld/seal/condensing is captured in jaw 1042, before or after tissue between 1044, perhaps before or after cutting off tissue by I ellbeam cutter 770, user can make jaw 1042,1044 around its longitudinal axis rotated about ninety degrees and by jaw 1042, and the outside of 1044 compresses organizationally with sealing/coagulating tissue.Particularly, outer electrode band 1066,1068 can compress organizationally by user, described organize available bipolarity radio-frequency (RF) energy be energized with the regional seal/coagulating tissue between the contact tissue point along outer electrode band 1066,1068.It should also be understood that, neither use jaw 1042 wherein, any inside of 1044 welds/seals/and coagulating tissue is not when using I ellbeam cutter 770 (or further feature structure) to cut off tissue yet, and outer electrode band 1066,1068 can be used to seal/coagulating tissue.

v. there is staggered toothed exemplary jaw

In some cases, may need to have toothed jaw, described tusk has the location that the length along described jaw replaces.This type of configuration can be provided for being clamped by tissue and remaining on the ability of the enhancing between jaw.This type of configuration also can provide the tissue welding/sealing/coagulability of enhancing.In addition or alternatively, this type of configuration can such as by reducing the tissue that extruding shank 12,14 be conducive between cut-out jaw with the power cut off needed for tissue.Figure 24-26 shows has tusk 1152, the exemplary variation of the jaw 1142,1144 of 1154, and described tusk has along jaw 1142, the position that the length of 1144 replaces.Particularly, tusk 1152 is positioned at the opposite side of the vertical line that the center along lower jaw 1142 extends asymmetrically.Tusk 1154 is positioned at the opposite side of the vertical line that the center along upper jaw 1142 extends asymmetrically.A series of groove 1156 by tusk 1152 along lower jaw 1142 separately, thus forms checkerboard type pattern; And a series of similar groove 1158 by tusk 1154 along upper jaw 1144 separately, thus also form checkerboard type pattern.

As finding best in Figure 25-26, tusk 1152,1154 and groove 1156, the spacing of 1158 is configured to when jaw 1142,1144 closed together time, tusk 1152 is nested in complemental groove 1158, and tusk 1154 is nested in complemental groove 1156.In this example, each tusk 1152,1154 comprises electrically insulating material, and groove 1156,1158 presents conductive surface.Such as, jaw 1142,1144 can be formed by conductive material (such as, metal) substantially, wherein tusk 1152,1154 are formed as jaw 1142, the feature structure of the one of 1144, and wherein tusk 1152,1154 use electrically insulating material (such as, plastics) coating, to make groove 1156, the conductive material of 1158 exposes.As another only illustrative example, jaw 1142,1144 can be formed by the conductive material (such as, metal) presenting smooth internal clamp port surface substantially, wherein tusk 1152,1154 completely by electrically insulating material (such as, plastics) formed, be then fixed to jaw 1142, the flat inner surface of 1144, to make groove 1156, the conductive material of 1158 exposes.With reference to instruction content herein, can in order to form tusk 1152, other suitable method of 1154 will be apparent for those of ordinary skill in the art.It is also understood that one or more edges of each tusk 1152,1154 comprise pressure and concentrate feature structure, such as convex ridge, convex peak, raised brim etc.

As being also shown in Figure 25-26, tusk 1152, the horizontal inner face 1153,1155 of 1154 is similar to above-mentioned zone 62, and 72 is oblique angle.Groove 1156 surface of lower jaw 1142 has negative bias, and groove 1158 surface of upper jaw 1144 has positive bias.This configuration provides radio-frequency (RF) energy to travel across from groove 1156 surface to horizontal associated recesses 1158 surface and is clamped in jaw 1142, the inclination transverse path of the tissue between 1144.In addition, the distal face 1176 of the distal face 1172 of tusk 1152 and the proximal side 1174 of tusk 1152 and tusk 1154 and the proximal side 1178 of tusk 1154 are oblique angle.Therefore these configurations provide radio-frequency (RF) energy to travel across from groove 1156 surface to longitudinal associated recesses 1158 surface and are clamped in jaw 1142, the inclination longitudinal path of the tissue between 1144.In other words, radio-frequency (RF) energy can at groove 1156, between 1158 surfaces along slant path distally/proximally advance and at groove 1156, laterally advance along slant path between 1158 surfaces.In some other patterns, tusk 1152,1154 is spaced apart, make when jaw 1142,1144 closed together time larger gap be positioned at face 1153, between 1155, face 1172, between 1178 and/or face 1174, between 1176, make the face 1153,1155 corresponding when jaw 1142,1144 is closed together, face 1172,1178 and/or face 1174,1176 will not be tending towards contacting with each other.With reference to instruction content herein, tusk 1152, other suitable configuration and the layout of 1154 will be apparent for the ordinary skill in the art.

Jaw 1142,1144 also comprise distally tusk 1162 and distally tusk nest 1164.Tusk 1162 has triangular outline and in this example at jaw 1142,1144 closed together time fit in tusk nest 1164, as shown in figure 24.In some cases, the combination of distally tusk 1162 and distally tusk nest 1164 can to jaw 1142, and 1144 essences providing larger tissue clamping to control and/or be similar to Maryland dissector etc. tear dissection ability.In addition or alternatively, the combination of distally tusk 1162 and distally tusk nest 1164 can provide contrary electrode essence to burn (such as, and by tusk 1152, the total unusual fluctuation of 1154 bias electrode provided is burnt and compared).Certainly, distally tusk 1162 and distally tusk nest 1164 can have any suitable configuration and ability.It is also understood that if needs, distally tusk 1162 and/or distally tusk nest 1164 can be omitted completely.

vI. there is the exemplary jaw of outside blunt separation feature structure

In some cases, user may wish to use jaw 42, and 44 perform blunt separation.Such as, user may be wished jaw 42, and 44 are driven in tissue a tissue part to be separated with another tissue part in same anatomical structure.As another example, user may wish to drive jaw 42,44, effectively the tissue of an anatomical structure and described contiguous anatomical structure to be peeled off between an anatomical structure and contiguous anatomical structure.The operation of this type of blunt separation can along with jaw 42, and 44 remain closed together and perform.In addition, user is by performing blunt separation with under type: tissue in or between open jaw 42,44, make the jaw 42,44 opened can contribute to chorista and/or anatomical structure.Figure 27-28 shows can be provided to strengthen jaw 42, the exemplary feature structure of the blunt separation ability of 44.With reference to instruction content herein, other examples of blunt separation feature structure will be apparent for the ordinary skill in the art.Should be appreciated that blunt separation feature structure as herein described can be easy to be applied to any one in jaw as herein described.In addition, should be appreciated that can use jaw weld/seal/condense and/or cut off organize before or after use blunt separation feature structure as herein described.

Figure 27 shows a pair jaw 1242,1244, and described jaw has the horizontal wedge shaped features structure 1246,1248 of respective sets exemplary external.Horizontal wedge shaped features structure 1246,1248 is formed the angled fin limiting respective transversal open angle.These angles all have corresponding summit, described summit along being parallel to jaw 1242, the longitudinal axis of 1244 and the axis location be laterally biased with described longitudinal axis.When jaw 1242,1244 along transverse to jaw 1242, the movement path of the longitudinal axis of 1244 in tissue/between time, horizontal wedge shaped features structure 1246,1248 can strengthen blunt separation ability.When jaw 1242,1244 location in the tissue or between organizational structure and jaw 1242,1244 then keeping laterally/longitudinally fixing while when opening, horizontal wedge shaped features structure 1246,1248 can prevent jaw 1242 substantially, and 1244 skid off the position relative to tissue.Horizontal wedge shaped features structure 1248 also can be used for scraping tissue and/or performs other action.In addition, when jaw 1242,1244 along being parallel to jaw 1242, the movement path of the longitudinal axis of 1244 in tissue/between time, horizontal wedge shaped features structure 1246,1248 can be used for manipulating tissue.With reference to instruction content herein, other suitable variations of horizontal wedge shaped features structure 1246,1248 and purposes will be apparent for the ordinary skill in the art.

Figure 28 shows a pair jaw 1342,1344, and wherein upper jaw 1344 has outside superiors's ridge 1348 of the outer surface longitudinal extension along upper jaw 1344.Although not shown, should be appreciated that lower jaw 1342 also can have peak ridge.Peak ridge 1348 extends along the total length of upper jaw 1344 in this example, but should be appreciated that peak ridge 1348 can extend along any suitable length.In addition, peak ridge 1348 is along being parallel to jaw 1342, and the path of the longitudinal axis of 1344 extends, but peak ridge 1348 can alternatively extend along other suitable path any.Peak ridge 1348 is point in this example, but peak ridge 1348 can be rounding on the contrary or have other suitable configuration any.With reference to instruction content herein, other suitable configuration of peak ridge 1348 will be apparent for the ordinary skill in the art.Should be appreciated that peak ridge 1348 can such as by making by jaw 1342, a large amount of pressure that the outside of 1344 applies concentrate the pressure concentrated area provided against tissue along peak ridge 1348.Peak ridge 1348 also can contribute to keeping jaw 1342,1344 relative to the located lateral of tissue when jaw 1342,1344 is opened while arranging in the tissue or between organizational structure.Peak ridge 1348 also can be used for scraping tissue and/or performs other action.With reference to instruction content herein, other suitable variations of peak ridge 1348 and purposes will be apparent for the ordinary skill in the art.

Figure 29 shows a pair jaw 1442,1444, and described jaw has respective sets exemplary external zigzag feature structure 1446,1448.Zigzag feature structure 1446,1448 is formed the angled tusk limiting corresponding proximally open angle.These angles all have along jaw 1442, the respective vertices of the longitudinal axis of 1444 location.When jaw 1442,1444 along being parallel to jaw 1442, the movement path of the longitudinal axis of 1444 in tissue/between time, zigzag feature structure 1446,1448 can strengthen blunt separation ability.When jaw 1442,1444 location in the tissue or between organizational structure and jaw 1442,1444 then keeping laterally/longitudinally fixing while when opening, zigzag feature structure 1446,1448 can prevent jaw 1442 substantially, and 1444 skid off the position relative to tissue.Zigzag feature structure 1446,1448 also can be used for scraping tissue and/or performs other action.In addition, when jaw 1442,1444 along transverse to jaw 1442, the movement path of the longitudinal axis of 1444 in tissue/between time, zigzag feature structure 1446,1448 can be used for manipulating tissue.With reference to instruction content herein, other suitable variations of zigzag feature structure 1446,1448 and purposes will be apparent for the ordinary skill in the art.

vII. exemplary clamp control piece

As above with reference to as described in Fig. 1-3, can use single button 16 come optionally active electrode surface with to being clamped in jaw 42, the tissue delivery radio-frequency (RF) energy between 44.In some these type of patterns, just activated Shi Yiyi group operating parameter (such as, frequency, amplitude etc.) at button 16 connects radio-frequency (RF) energy to single button 16.Radio-frequency (RF) energy is just closed when button 16 is released.In some cases, may need based on pending specific operation be provided for radio-frequency (RF) energy more than one group of parameter.Such as, tissue welding operation can need the first radio-frequency (RF) energy parameter combinations (such as, comparatively short arc etc.), and tissue cutting actions can need the second radio-frequency (RF) energy parameter combinations (such as, higher amplitudes etc.).For this reason, may need to provide one or more user input feature vector structure, described feature structure can operate optionally activate radio-frequency (RF) energy with the combination of the energy parameter of the most applicable task at hand.Below by several only illustrative example of this type of user input feature vector structure of more detailed description, but with reference to instruction content herein, other example will be apparent for the ordinary skill in the art.Should be appreciated that following instruction content can be easy in various arrangement mode and anyly above instruct content combinations.

Figure 30 shows exemplary clamp apparatus 1510, and described apparatus comprises the shank 1512,1514 that a pair jaw 1542,1544 and a pair provides scissor grip part.Lower shank 1512 comprises a pair veining trigger button 1516,1518.Nearside trigger button 1516 can operate to utilize the radio-frequency (RF) energy of the first operating parameter combination to activate jaw 1542, the electrode surface of 1544; And distally trigger button 1518 can operate to utilize the radio-frequency (RF) energy of the second operating parameter combination to activate jaw 1542, the electrode surface of 1544.Only by way of example, nearside trigger button 1516 can utilize the radio-frequency (RF) energy of the parameter combinations be associated with tissue welding/sealing/condensation to activate jaw 1542, the electrode surface of 1544; And distally trigger button 1518 can utilize and organize the radio-frequency (RF) energy of cutting the parameter combinations be associated to activate jaw 1542, the electrode surface of 1544.As shown in the figure, nearside trigger button 1516 is greater than distally trigger button 1518, thus to user provide only based on touch perception without the need to observing trigger button 1516,1518 distinguish trigger button 1516, the ability of 1518.

Certainly, trigger button 1516,1518 can take various alternate forms, and with reference to instruction content herein, this will be apparent for the ordinary skill in the art.Such as, trigger button 1516,1518 can be configured to the flexible foaming material of proximally and distally locating, the button with different size, there is difform button, slider switch, the switch with multiple movable position, the button with different colours or other suitable variations any, with reference to instruction content herein, this will be apparent for the ordinary skill in the art.It is also understood that apparatus 1510 can have more than two trigger buttons (such as, to provide the selective activation more than two radio-frequency (RF) energy parameter combinations, etc.).In addition, except or replace with second parameter combinations activate radio-frequency (RF) energy, distally trigger button 1518 can operate to activate I ellbeam cutter or other movable Cutting feature structure.

Figure 31 shows exemplary clamp apparatus 1610, and described apparatus comprises a pair jaw 1642,1644, the shank 1612,1614 providing scissor grip part for a pair and single veining trigger button 1616.Trigger button 1616 proximally can be moved by the gradual motion of a series of two scopes in two independently stage.Particularly, trigger button 1616 distally proximally can move to crossover position in position.In this stage, trigger button 1616 utilizes the radio-frequency (RF) energy of the first operating parameter combination to activate jaw 1642, the electrode surface of 1644.Only by way of example, the combination of this first operating parameter can be associated with tissue welding/sealing/condensation.Trigger button 1616 proximally can also move to proximal position from crossover position.In this stage, trigger button 1616 utilizes the radio-frequency (RF) energy of the second operating parameter combination to activate jaw 1642, the electrode surface of 1644.Only by way of example, the combination of this second operating parameter can be associated with organizing cutting.

Should be appreciated that and ratchet and/or further feature structure can be used to provide instruction first range of movement to complete the feedback of (that is, indicating user to arrive crossover position) to user.This type of feedback characteristic structure can provide sense of touch and/or auditory feedback to user.In addition or alternatively, the visual feedback of lamp or other form can be used as to the form of the feedback of user.Certainly, trigger button 1616 can take various alternate forms, and with reference to instruction content herein, this will be apparent for the ordinary skill in the art.It is also understood that trigger button 1616 can have more than two active positions (such as, to provide selective activation more than two radio-frequency (RF) energy parameter combinations etc.) in its range of movement.In addition, except or replace with second parameter combinations activate radio-frequency (RF) energy, the proximal position actuatable I ellbeam cutter of trigger button 1616 or other movable Cutting feature structure.

Should be appreciated that apparatus 1510,1610 are configured to make user can be easy to use the same finger of the hands gripping apparatus 1510,1610 to perform the self contained function of tissue welding/sealing/condensation and cutting.In some cases, may need to use different fingers to perform the self contained function of welding/sealing/condensation and cutting.Figure 32 shows exemplary clamp apparatus 1710, described apparatus is conducive to using different fingers to perform the self contained function of welding/sealing/condensation and cutting, but be to be understood that, if needed, user still can use same finger to utilize apparatus 1710 to perform the self contained function of welding/sealing/condensation and cutting.The apparatus 1710 of this example comprises a pair jaw 1742,1744, the shank 1712,1714 providing scissor grip part for a pair, distally trigger button 1716 and nearside pivotable trigger 1718.As shown in the figure, distally trigger button 1716 is oriented to be activated by the forefinger of user; And nearside pivotable trigger 1718 is oriented to be activated by the middle finger of the same hand.Nearside pivotable trigger 1718 can at pivot coupling 1720 place relative to shank 1712 pivotable.

Distally trigger button 1716 can operate to utilize the radio-frequency (RF) energy of the first operating parameter combination to activate jaw 1742, the electrode surface of 1744; And nearside pivotable trigger 1718 can operate to utilize the radio-frequency (RF) energy of the second operating parameter combination to activate jaw 1742, the electrode surface of 1744.Only by way of example, the radio-frequency (RF) energy of the parameter combinations that distally trigger button 1716 can be associated with tissue welding/sealing/condensation to activate jaw 1742, the electrode surface of 1744; And nearside pivotable trigger 1718 can cut the radio-frequency (RF) energy of the parameter combinations be associated to activate jaw 1742 with tissue, the electrode surface of 1744.Should be appreciated that except or replace activating radio-frequency (RF) energy with the second parameter combinations, nearside pivotable trigger 1718 can operate to activate beam cutter or other movable Cutting feature structure.

Figure 33 A-33C shows exemplary clamp apparatus 1810, and described clamp apparatus has the shank 1812,1814 and jaw 1842,1844 that can operate to clamp also seal tissue.The apparatus 1810 of this example also comprises trigger 1816, and described trigger can operate to control jaw 1842, the energising of 1844 and can operate to limit jaw 1842, the motion of 1844.Trigger 1816 is connected with shank 1812 pivotally by pin 1824; And can around pin 1824 relative to shank 1812 pivotable.Trigger 1816 also comprises the button 1820 can pressed by user.Button 1820 can operate to utilize radio-frequency (RF) energy to activate jaw 1842 as mentioned above, the electrode surface of 1844, thus welding/sealing/condensation is captured in jaw 1842, the tissue between 1844.

The top of trigger 1816 comprises the seat 1822 be shaped as with the downside complementation of upper shank 1814.Trigger 1816 can around pin 1824 pivotable in the range of movement shown in Figure 33 A-33C.Particularly, when trigger 1816 is in general vertical position, trigger 1816 makes shank 1812,1814 can as shown in the transition from Figure 33 A to Figure 33 B partly pivotable toward each other.This provide jaw 1842, the part of 1844 closes.When shank 1812,1814 and jaw 1842,1844 when reaching the position shown in Figure 33 B, shank 1814 is received in seat 1812 and trigger 1816 stops shank 1812, and 1814 and the further pivotable of jaw 1842,1844.The length of trigger 1816 is selected to and provides jaw 1842 in this stage, the specific gap between 1844.This gap is associated with tissue compression degree, and described tissue compression degree is associated with tissue welding/sealing/condensation.Such as, this gap can be similar to the jaw 342 shown in Figure 10 B, the distance between 344.In this stage, user can press push button 1820 to utilize radio-frequency (RF) energy to activate jaw 1842, the electrode surface of 1844, thus welding/sealing/condensation be captured in jaw 1842, the tissue between 1844.

Utilize radio-frequency (RF) energy press push button 1820 to activate jaw 1842 as mentioned above at user, the electrode surface of 1844, and organizing by after abundant welding/sealing/condensation between jaw, user can press trigger 1816 by additional power and be pivoted to the position shown in Figure 33 C to make trigger 1816 from the position shown in Figure 33 B.This makes seat 1822 move into be disengaged with upper shank 1814, and to provide shank 1812,1814 by the space of furthering together, thus makes jaw 1842, and 1844 can drive further toward each other.Particularly, the Distance geometry power that user this moment can be enough is by jaw 1842, and 1844 drive toward each other to cut off and are captured in jaw 1842, the tissue between 1844.Such as, along with trigger 1816 is pivoted to the position shown in Figure 33 C from the position shown in Figure 33 B, jaw 1842,1844 positions that can reach the location being similar to the jaw 342,344 shown in Figure 10 C.According to above-mentioned, should be appreciated that trigger 1816 can be used for guaranteeing suitably welding/sealing/coagulating tissue before cutting and organizing.In other words, the temporary transient stop of trigger 1816 to lower shank 1814 can remind user activator button 1820, thus welding/sealing before completing the action cut and organized/coagulating tissue.In this example, trigger 1816 is resiliently biased the position shown in Figure 33 A, thus stops the acquiescence of jaw 1842,1844 completely closed.

Figure 34 A-34C shows has jaw 1942, and 1944 and another exemplary clamp apparatus 1910 of shank 1912,1914.Apparatus 1910 also comprises the trigger 1916 with button 1920.Trigger 1916 is positioned in the groove 1922 of shank 1912, and trigger 1916 can be slided in groove 1922.Figure 34 B shows shank 1912, and 1914 are promoted with closed jaw 1942,1944 toward each other; And button 1920 is depressed.Button 1920 can operate to utilize radio-frequency (RF) energy to activate jaw 1942 when button 1920 is depressed as illustrated in figure 34b, the electrode surface of 1944, welding/to seal/and condense the tissue be captured between jaw 1942.The apparatus 1910 of this example also comprises pivotable cutter 1970.Cutter 1970 comprises blade, and described blade can, through the groove of the longitudinal extension be formed in upper jaw 1944, make cutter 1970 can be pivoted to lower position (Figure 34 C) from upper position (Figure 34 B).Cutter 1970 is connected in same joint 1980 place connecting jaw 1942,1944 and shank 1912,1914 in this example pivotally, but should be appreciated that and can use independent coupling.

The proximal end of cutter 1970 presents the lever arm 1971 engaged by trigger 1916.Particularly, when trigger 1916 relative to shank 1912 upwardly time, trigger 1916 is boosted lever arm 1971.Owing to being provided in the pivot at joint 1980 place, this of lever arm 1971 moves upward the moving downward of blade provided as the cutter 1970 seen in the transition from Figure 34 B to Figure 34 C.This of the blade of cutter 1970 moves downward cut-out and is captured in jaw 1942, the tissue between 1944.In some patterns, lower jaw 1942 provides cutting plate, and cutting plate effect described in the insert abutment of cutter 1970 is captured in jaw 1942, the tissue between 1944 to cut off.In this example, select spring bias, button 1920 is significantly less than from the strength moved to needed for the position shown in Figure 34 B of the position shown in Figure 34 A and makes trigger 1916 move to the strength needed for the position shown in Figure 34 C from the position shown in Figure 34 A-34B.Therefore, when user upwards pushes down button 1920 and trigger 1916, button 1920 will be fully depressed before trigger 1916 moves in groove 1922, make jaw 1942, the forward direction that the electrode surface of 1944 will cut off tissue at cutter 1970 is captured in jaw 1942, and the tissue between 1944 provides bipolarity radio-frequency (RF) energy.

In the example shown in Figure 34 A-34C, activate cutter 1970 by promoting trigger 1916 along the path substantially transverse to shank 1912.In some other patterns, promote trigger to activate cutter along the path being in substantially parallel relationship to shank.Such as, Figure 35-36B shows exemplary clamp apparatus 2010, and described apparatus has a pair shank 2012,2014, a pair jaw 2042,2044 and longitudinal sliding motion trigger 2016.Apparatus 2010 also comprises the cutter 2070 with sharp edges 2071, and described cutter can operate to cut off and be clamped in jaw 2042, the tissue between 2044.The cutter 2070 of this example also comprises pin 2022 and the nearside engagement leg 2024 of a pair horizontal expansion.Pin 2022 is arranged in the oblique angle groove 2020 be formed in upper jaw 2044.The configuration of groove 2020 and the relation between groove 2020 and pin 2022 provide when distally/proximally drive cutter 2070 time cutter 2070 moving along vertical plane.Particularly, cutter 2070 will move downward when distally position moves to proximal position at cutter 2070; And will move upward when proximally position moves to distal position at cutter 2070.Figure 36 A shows cutter 2070 and is in top distal position.Figure 36 A shows cutter 2070 and is in bottom proximal position, and described bottom proximal position is that cut-out is captured in jaw 2042 by cutter 2070, the position of the tissue between 2044.

As shown in figure 35, the nearside engagement leg 2024 of cutter 2070 connects with trigger 2016.Trigger 2016 proximally can slide relative to shank 2012.Therefore, user can relative to shank 2012 proximally tractive trigger 2016 with proximally tractive cutter 2070, thus cutter 2070 to be driven to cut off tissue downwards.Cutter 2070 by distally elastic biasing, thus is biased to the upper position shown in Figure 36 A by the trigger 2016 of this example.Should be appreciated that trigger 2016 can comprise the activation feature structure being similar to above-mentioned button 1920, optionally to utilize bipolarity radio-frequency (RF) energy to activate jaw 2042, the electrode surface of 2044.This type of button can be arranged to stage actuating together with trigger 2016, makes, before tissue is cut off by cutter 2070, radio-frequency (RF) energy is applied to tissue.

Figure 35-36B shows to have and uses cutter 2070 to cut and be clamped in jaw 2042, the exemplary alternative pattern of the clamp apparatus 2010 of the alternative means of the tissue between 2044.Jaw 2044 comprises the cam feature structure 2022 of the cam path 2020 that can operate to engage cutter 2070.Cutter 2070 has the shape of the profile substantially following jaw 2044 in the mode at angle.Cutter 2070 also comprises the engagement leg 2024 that can operate to engage trigger 2016.Particularly, trigger 2016 can be activated to make cutter 2070 move to the position of the cutter 2070 shown in Figure 36 B from the position shown in Figure 36 A by user.Trigger 2016 proximally moves against engagement leg 2024, thus proximally tractive cutter 2070.When cutter 2070 proximally moves, cutter 2070, also to incision, makes jaw 2042, and any tissue between 2044 will be cut by cutter 2070.Should be appreciated that in some patterns, cutter 2070 can be biased to and present the position shown in Figure 36 A by spring.

Figure 37-38E shows clamp apparatus 2110 together with for making tissue be energized and another exemplary alternative pattern of the feature structure cut and organized.The apparatus 2110 of this example comprises a pair shank 2112,2114 and corresponding a pair jaw 2142,2144, and described jaw can operate to clamp and be captured in jaw 2142, and the tissue between 2144 also makes it be energized.Apparatus 2110 also comprises trigger 2116, described trigger be communicated with coupling 2118 and can operate with together with coupling 2118 along shank 2112,2114 motion.As finding best in Figure 37, coupling 2118 limits passage 2124 and link arm 2126.Shank 2114 is arranged in passage 2124 in the mode that can slide, and coupling 2118 can be slided along shank 2114.Link arm 2126 connects with trigger 2116, and make when user presses trigger 2116, coupling 2118 slides along shank 2114.Should be appreciated that coupling 2118 and trigger 2116 can be biased to and present the position shown in Figure 38 A.

The shank 2114 of this example comprises a pair fragment, and described fragment is bonded on joint 2120 place and can operates to be pivoted relative to each other at joint 2120 place.Shank 2114 also comprises pivot links 2122, and described pivot links is communicated with translation cutter 2170 pivot, makes connecting rod 2122 can operate distally advance cutter 2170 in response to shank 2114 towards shank 2112 pivotable.Figure 38 B shows shank 2114, and to be pivoted to wherein jaw 2142,2144 completely closed and be oriented to the position of grip tissue thus.It should be pointed out that coupling 2118 is being positioned at above joint 2120 from the transition period of Figure 38 A to Figure 38 B, and thus prevent the fragment of shank 2114 in joint 2120 place pivotable.In other words, coupling 2118 keeps substantially straight at the transition period chien shih shank 2114 from Figure 38 A to Figure 38 B.

At jaw 2142,2144 clamped tissue after, then can as finding distally actuating trigger 2116 in figure 38 c, with to jaw 2142,2144 apply bipolarity radio-frequency (RF) energy welds/sealing/coagulating tissue.The trigger 2116 of distally locating also by jaw 2142,2144 be latched in the close position together.When distally actuating trigger 2116, also make coupling 2118 distally slide along shank 2114, make coupling 2118 no longer surround joint 2120.Be in distal position along with coupling 2118 and be effectively released along with joint 2120, user subsequently can by shank 2112,2114 extrude further toward each other, thus make the nearside fragment of shank 2114 at joint 2120 place the distally fragment pivotable relative to shank 2112.The distal end of connecting rod 2122 distally drives by this further pivotable of the nearside fragment of shank 2114, then distally drives cutter 2170 to cut off being captured in jaw 2142, the tissue between 2144.Cutter 2170 can have I ellbeam configuration or other suitable configuration any.Organize cut-off after, user can discharge shank 2114 and by trigger 2116 proximally tractive return, thus make apparatus 2110 reset to the position shown in Figure 38 E.

The feature structure of clamp apparatus 1810 of clamp apparatus 2210 constitutional diagram 33A-33C shown in Figure 39-40B and the feature structure of the clamp apparatus 1910 of Figure 34 A-34C.Particularly, the apparatus 2210 of this example comprises shank 2212,2214, jaw 2242,2244, pivotable trigger 2216 and pivotable cutter 2270.Trigger 2216 to be connected pivotally with shank 2212 by pin 2217 and can operate optionally limit jaw 2242, the motion of 2244 by optionally stop shank 2212 towards the motion of shank 2214.Although Figure 29-40B is not shown, but be to be understood that, trigger 2216 also can comprise the feature structure being similar to above-mentioned button 1820, described feature structure can optionally utilize radio-frequency (RF) energy to activate jaw 2242 as mentioned above, the electrode surface of 2244, thus welding/sealing/condensation is captured in jaw 2242, the tissue between 2244.

The top of trigger 2216 comprises the seat 2220 be shaped as with the downside complementation of upper shank 2214.Trigger 2216 can around pin 2217 pivotable in the range of movement shown in Figure 40 A-40B.Particularly, when trigger 2016 is in general vertical position, trigger 2016 makes shank 2212,2214 can as shown in the transition of the A from Figure 39 to Figure 40 partly pivotable toward each other.This provides jaw 2242, and the part of 2244 closes.When shank 2212,2214 and jaw 2242,2244 when reaching the position shown in Figure 40 A, shank 2214 is received in seat 2220 and trigger 2216 stops shank 2212, and 2214 and the further pivotable of jaw 2242,2244.The length of trigger 2216 is selected to and provides jaw 2242 in this stage, the specific gap between 2244.This gap is associated with tissue compression degree, and described tissue compression degree is associated with tissue welding/sealing/condensation.Such as, this gap can be similar to the jaw 342 shown in Figure 10 B, the distance between 344.In this stage, user can utilize radio-frequency (RF) energy to activate jaw 2242, the electrode surface of 2244, thus welding/sealing/condensation is captured in jaw 2242, the tissue between 2244.

Radio-frequency (RF) energy is utilized to activate jaw 2242 as mentioned above at user, the electrode surface of 2244, and organizing by after abundant welding/sealing/condensation between jaw, user can be pushed down trigger 2216 and be pivoted to the position shown in Figure 40 B to make trigger 2216 from the position shown in Figure 40 A.This makes seat 2220 move into be disengaged with upper shank 2214, and to provide shank 2212,2214 by the space of furthering together, thus makes jaw 2242, and 2244 can drive further toward each other.This additional space also makes shank 2214 can activate pivotable cutter 2270, as will be described in more detail.

The cutter 2270 of this example comprises blade, and described blade can, through the groove of the longitudinal extension be formed in upper jaw 2244, make cutter 2270 can be pivoted to lower position (Figure 40 B) from upper position (Figure 40 B).Cutter 2270 is connected in same joint 2280 place connecting jaw 2242,2244 and shank 2212,2214 in this example pivotally, but should be appreciated that and can use independent coupling.The proximal end of cutter 2270 presents the lever arm 2271 engaged by actuator arm 2218, and described actuator arm is fixed to lower shank 2212 pivotally.Actuator arm 2218 bends to obtuse angle in this example, wherein the downside of distal part engagement lever arm 2271.The portions of proximal of actuator arm 2218 is positioned for being engaged by the projection 2115 of upper shank 2214.Particularly, when upper shank 2214 is pivoted to the position shown in Figure 40 B from the position shown in Figure 40 A, the portions of proximal of actuator arm 2218 drives downwards by projection 2115.This causes the distal part upwards pivotable of actuator arm 2218, is then upwards driven by the lever arm 2271 of cutter 2270.This of lever arm 2271 moves upward the moving downward of blade provided as the cutter 2270 seen in the transition from Figure 40 A to Figure 40 B.This of the blade of cutter 2270 moves downward cut-out and is captured in jaw 2242, the tissue between 2244.In some patterns, lower jaw 2242 provides cutting plate, and cutting plate effect described in the insert abutment of cutter 2270 is captured in jaw 2242, the tissue between 2244 to cut off.

Figure 41-42C shows another the exemplary pattern being not intended to the clamp apparatus 2310 activated that can operate to prevent cutter 2370.The apparatus 2310 of this example comprises shank 2312, and 2314 and jaw 2342,2344.Cutter 2370 extends longitudinally through axle 2313 and can operate distally to advance to cut to be clamped in jaw 2342, the tissue between 2344.The distal part of cutter 2370 has I ellbeam configuration in this example, but should be appreciated that and can use other suitable configuration any.Shank 2314 has the bending distal part 2320 connected pivotally with connecting rod 2322, and described connecting rod connects pivotally with the proximal end of cutter 2370 further.Apparatus 2310 also comprises trigger 2316, and described trigger can operate optionally to prevent shank 2314 from moving towards shank 2312.Particularly, and as in Figure 42 A best finding, the shaft 2317 of trigger 2316 engages the recess 2318 be formed in the distal part 2320 of shank 2314, makes trigger 2316 can operate to stop the motion of shank 2314.

As shown in Figure 42 B, trigger 2316 can pivotable depart from from recess 2318 to make shaft 2317, thus release shank 2314.Along with shank 2314 slave flipflop 2316 discharges, user can make shank 2314 towards shank 2312 pivotable, also as shown in Figure 42 B.Cutter 2370 distally drives via connecting rod 2322 by this motion of shank 2312.Cutter 2370 has upper flange 2372 and lower flange 2373, and described upper flange and described lower flange and jaw 2342,2344 interact to be driven towards lower jaw 2342 by upper jaw 2344, make jaw 2342, and 2344 advance in response to the distally of cutter 2370 and close.Therefore jaw 2342,2344 and cutter 2370 can clamp when cutter 2370 distally drives and cut off tissue.In some patterns, jaw 2342,2344 also comprise electrode surface, and described electrode surface can operate with to being clamped in jaw 2342, the tissue delivery bipolarity radio-frequency (RF) energy between 2344, thus welding/sealing/coagulating tissue.Only by way of example, radio frequency activator button can be incorporated to other place in trigger 2316 and/or apparatus 2310.After the operation needed for apparatus 2310 has performed tissue, trigger 2314 can be discharged into the home position shown in Figure 41 by user.This by cutter 2370 proximally tractive return, thus final as shown in Figure 42 C by jaw 2342,2344 to returning out.If needed, user can be re-engaged in recess 2318 to make shaft 2317 by pivotable trigger 2316, thus relocks shank 2314 as shown in Figure 42 A.

Figure 43 A-43D shows has jaw 2442, and 2444 and another exemplary clamp apparatus 2410 of shank 2412,2414.Cutter 2470 can operate distally to be advanced through shank 2412 and be clamped in jaw 2442, the tissue between 2444 with cutting.The distal part of cutter 2470 has I ellbeam configuration in this example, but should be appreciated that and can use other suitable configuration any.Cutter 2470 connects pivotally with connecting rod 2422, and described connecting rod connects pivotally with shank 2414 further.Trigger 2416 can operate the distal movement optionally stoping cutter 2470.Particularly, trigger 2416 optionally can engage the lateral notch 2424 be formed in cutter 2470.When trigger 2416 engagement recesses 2424, cutter 2470 can not distally move.When trigger 2416 departs from from recess 2424, cutter 2470 freely distally moves.

Figure 43 A shows jaw 2442, and 2444 open.User by as seen in Figure 43 B by shank 2412,2414 press together closed jaw 2442,2444.When cutter 2470 is closed in shank 2412, trigger 2416 engages the recess 2424 of cutter 2470, and cutter 2470 cannot be advanced.Jaw 2442,2444 clamp and may be positioned at jaw 2442, the tissue between 2444.User then can active electrode surface, and described electrode surface can operate with to being clamped in jaw 2442, the tissue delivery bipolarity radio-frequency (RF) energy between 2444, thus welding/sealing/coagulating tissue.Only by way of example, radio frequency activator button can be incorporated to other place in trigger 2416 and/or apparatus 2410.Regardless of tractive trigger 2416, whether active electrode is surperficial, and user all can depart from, as shown in Figure 43 C from the recess 2424 of cutter 2470 to make trigger 2416 by tractive trigger 2416.Along with trigger 2416 departs from from recess 2424, user can complete the pivotable of shank 2414 towards shank 2412, thus is distally driven by cutter 2470 via connecting rod 2422, as shown in Figure 43 D.This distally of cutter 2470 advances cut-out to be captured in jaw 2442, the tissue between 2444.

Figure 44 A-44B shows the alternative assembly that the distally that can be used for optionally preventing cutter advances.Particularly, Figure 44 A-44B shows the cutter 2570 with I ellbeam distal end configuration and lateral notch 2572.Pin 2574 can operate with optionally engagement recesses 2572, thus optionally prevents cutter 2570 from distally being advanced.Pin 2574 is fixed to the distal end of electroactive layer zoarium 2550, and described electroactive layer fit 2550 connects with couple of conductor 2546,2548.

In some patterns, electroactive layer zoarium 2550 comprises the heat-sensitive material layer expanding in response to heat or shrink, and wherein said heat is transmitted through wire 2546 at electric current, generates when 2548.In some other patterns, electroactive layer zoarium 2550 comprises and is transmitted through wire 2546 in response to electric current, and 2548 and the layer of electroactive polymer that expands or shrink.With reference to instruction content herein, will be apparent for the ordinary skill in the art for other suitable material of electroactive layer zoarium 2550 and structure.As visible in Figure 44 B, make electric current pass wire 2546,2548 cause electroactive layer fit 2550 to bend, thus are driven into by pin 2574 and are disengaged with recess 2572, discharge cutter 2570 distally translation thus.Should be appreciated that this configuration (and modification) can be used for herein about can any one in the example described in moving knife.It is also understood that and logic circuit can be provided to pass wire 2546,2548 to prevent current flowing, until electrode applies bipolarity radio-frequency (RF) energy to tissue.Only by way of example, described circuit can prevent current flowing from passing wire 2546,2548, until fully weld/the level of seal tissue with organizing the resistance value that is associated to reach to indicate radio-frequency (RF) energy.With reference to instruction content herein, other suitable variations will be apparent for the ordinary skill in the art.

Figure 45-46 shows another exemplary clamp apparatus 2610, and described apparatus has jaw 2642, and 2644 and shank 2612,2614 and the mechanism for the propelling that controls cutter 2670.Apparatus 2610 comprises cutter 2670, and described cutter can operate advance in shank 2614 and comprise the distal end with I ellbeam configuration.Shank 2614 comprises the tooth bar 2620 engaged with a pair pinion 2622, and described pinion engages with the rack tooth 2672 on cutter 2670 further.When shank 2614 extrudes downwards towards shank 2612, tooth bar 2620 moves downward pinion 2622 is rotated, thus distally advances cutter 2670 as finding in figures 4-6 can.But use the spring with breech lock 2618 to be biased the propelling that trigger 2616 optionally prevents cutter 2670, described breech lock can operate with the proximal end place engaging receiver breech lock 2674 at cutter 2670.Breech lock 2618, the location of 2674 and configuration prevent cutter 2670 at breech lock 2618,2674 engaged time distally advance.Breech lock 2618,2674 depart from by user depression of trigger 2616, make user that trigger 2616 must be made to remain in depressing position distally to advance cutter 2670.Breech lock 2618 is biased to and engages with breech lock 2674 by spring 2617.Only by way of example, radio frequency activator button can be incorporated to other place in trigger 2616 and/or apparatus 2610, to provide the activation to electrode surface, described electrode surface can operate with to being clamped in jaw 2642, tissue delivery bipolarity radio-frequency (RF) energy between 2644, thus welding/sealing/coagulating tissue.

Figure 47 A-47B shows another exemplary pattern of clamp apparatus 2710, and described apparatus has jaw 2742, and 2744 and shank 2712,2714 and the mechanism for the propelling that controls cutter (not shown).Particularly, shank 2714 is communicated with connecting rod 2722, and described connecting rod can operate the recess 2724 engaging shank 2712.Joint between connecting rod 2722 and 2724 can be user slip cutter button 2772 and provides additional stability, as seen in Figure 47 B.Although cutter button 2772 is slider switch shown in described exemplary pattern, should be appreciated that cutter button 2772 can comprise any suitable switches, with reference to instruction content herein, this will be apparent for the ordinary skill in the art.Activate cutter button 2772 and can operate curved blades to be advanced through shank 2714 to cut jaw 2742, the tissue between 2744.In some patterns, shank 2714 is the propelling to be conducive to cutter flexible at least in part.Trigger 2716 can operate optionally to activate jaw 2742, the exposed electrode surface in 2744 with to being clamped in jaw 2742, the tissue delivery bipolarity radio-frequency (RF) energy between 2744, thus welding/sealing/coagulating tissue.

Figure 48 shows another exemplary pattern of clamp apparatus 2810, and described apparatus has jaw 2842, and 2844 and shank 2812,2814 and the mechanism for the propelling that controls cutter 2870.Apparatus 2810 comprises makes its shank trigger 2816 activated against shank 2812 by closed shank 2814.As seen in Figure 49 A, trigger 2816 forms the passage 2818 passed for cutter 2870.Trigger 2816 is biased to upwards position by spring 2820, as finding best in Figure 49 A.In this position, trigger 2816 is arranged in the lateral notch 2871 be formed in cutter 2870.This joint prevents cutter 2870 lengthwise movement.When closed shank 2814 makes it against shank 2812 with closed jaw 2842, when 2844, shank 2814 finally overcomes the biased of spring 2820 and is driven downwards by trigger 2816.As shown in Figure 49 B, this makes trigger 2816 depart from from lateral notch 2871 and cutter 2870 can distally be advanced.In some patterns, cutter 2870, by distally elastic biasing, makes trigger 2,816 one depart from from lateral notch 2871, and cutter 2870 is just by distally translation.In some other patterns, independent actuator is used distally to be driven by cutter 2870.Except effectively unlocking cutter 2870, trigger 2816 also trigger 2816 be driven to shown in Figure 49 B to closed electrical switch during upper/lower positions.Particularly, this connects and activates jaw 2842, the exposed electrode surface in 2844 with to being clamped in jaw 2842, the tissue delivery bipolarity radio-frequency (RF) energy between 2844, thus the circuit of welding/sealing/coagulating tissue.Alternatively, independent activation feature structure can be used to connect described circuit.

Figure 50 shows another exemplary pattern of clamp apparatus 2910, and described apparatus has jaw 2942, and 2944 and shank 2912,2914 and the mechanism for the propelling that controls cutter 2970.Cutter 2970 comprises the proximal end of the driving feature structure that the distal end with I ellbeam configuration and tool engage with gear 2926.Gear 2926 connects with the driving shaft 2930 of motor 2928.Therefore, motor 2928 can operate and be clamped in jaw 2942, the tissue between 2944 distally to be driven to cut off by cutter 2970.Shank 2912 comprises trigger 2916, described trigger can operate not only to activate motor 2928 but also activate jaw 2942, the exposed electrode surface in 2944, with to being clamped in jaw 2942, tissue delivery bipolarity radio-frequency (RF) energy between 2944, thus welding/sealing/coagulating tissue.In this example, trigger 2916 can provide the two benches being similar to above-mentioned trigger button 1616 to activate, make trigger 2916 can operate to activate bipolarity radio-frequency electrode when trigger 2916 is actuated to primary importance, and make trigger 2916 can operate to activate motor 2928 when trigger 2916 is actuated to the second position.Certainly, other suitable user input feature vector structure any can be provided.

Shank 2912 also comprises backstop apparatus 2920, and described backstop apparatus is oriented to the pivotable of stop shank 2914 towards shank 2912.Particularly, rotating cam 2922 is positioned in backstop apparatus 2920 below and can operate make according to the position of rotation of cam 2922 backstop apparatus 2920 remain in upper position or allow backstop apparatus 2920 to advance downwards.Motor 2924 can operate with optionally rotating cam 2922.The circuit communication that motor 2924 is identical with trigger 2916.Control logic can activate motor 2924 in response to one or more situations.In some patterns, motor 2924 activates when trigger 2916 is actuated into the second position.In addition or alternatively, only have after reaching the second position at trigger 2916 with organize the resistance value be associated to reach to indicate radio-frequency (RF) energy fully weld/level of seal tissue time, control logic just can activate motor 2924.With reference to instruction content herein, will be apparent for the ordinary skill in the art for activating other appropraite conditions of motor 2924.Should be appreciated that when backstop apparatus 2920 is in upper position, jaw 2942,2944 because of shank 2914 can not advance to only towards shank 2912 pivotable completely local make position.Even if in this partial closed position, jaw 2942,2944 also enough clamp organizationally with welding/sealing/coagulating tissue.But jaw 2942, the only part of 2944 is closed will prevent cutter 2970 can distally be translated across jaw 2942,2944.In other words, jaw 2942,2944 must close completely in this example and just can make cutter 2970 distally translation, and jaw 2942,2944 completely closed only has and just become possibility when backstop apparatus 2920 is in during upper/lower positions.

vIII. example energy controlling feature structure

In the above-described example, use the user input feature vector structure of trigger, button or other type optionally to activate the exposed electrode surface in jaw, with to the tissue delivery bipolarity radio-frequency (RF) energy be clamped between jaw, thus welding/sealing/coagulating tissue.In some cases, these user input feature vector structures can activate before jaw adequate closure organizationally.Therefore, in some cases, may need to provide the electrode surface requiring jaw can be delivered in jaw in radio-frequency (RF) energy before be closed into circuit features to a certain degree.Below by several examples of this type of feature structure of more detailed description, but with reference to instruction content herein, other example will be apparent for the ordinary skill in the art.Should be appreciated that the user input feature vector structure that following characteristics structure can be used to supplement or replace trigger, button or other type.In other words, following characteristics structure can be used to the automatic activation (such as, making trigger, button or other user input feature vector structure be omitted) providing electrode when jaw adequate closure; Or provide circuit interlocking part or safety switch to become and can not operate to make the user input feature vector structure of trigger, button or other type, until jaw adequate closure.With reference to instruction content herein, will be able to be apparent for the ordinary skill in the art in order to following instruction content to be incorporated to the various suitable methods of above-mentioned multiple apparatus.

Figure 51 A shows the exemplary pattern of clamp apparatus 3010, and described apparatus has jaw 3042, and 3044 and shank 3012,3014 and flow through the mechanism of apparatus 3010 for controlling electricity.First wire 3046 is communicated with the one or more electrode surfaces in jaw 3044; And the second wire 3048 and the one or more electrode surface electric connections in jaw 3042.Privates 3050 is communicated with power source (not shown) with the first wire 3046.Privates 3050 is also communicated with the first ratchet contact pad 3018 of shank 3012; And the second wire 3048 is communicated with the second ratchet contact pad 3020 of shank 3014.First pad 3018 and the second pad 3020 can at shanks 3012,3014 toward each other pivotable with closed jaw 3042, mesh together when 3044.When pad 3018,3020 when being linked together, and the power path between the second wires 3048 and privates 3050 connected by pad 3018,3020, thus connected with power source by the second wire 3048.Along with the first wire 3046 and the second wire 3048 connect with power source, power source can operate with guiding line 3046, and 3048 send bipolarity radio-frequency (RF) energy, thus welding/sealing/condensation is clamped in jaw 3042, the tissue between 3044.

Figure 52 shows another exemplary pattern of a part for the shank 3112,3114 with slip ring 3120, and described slip ring is for stoping energy Flow, unless shank 3112,3114 closes.Particularly, insulated conductor 3122 disconnects at slip ring 3120 place, until shank 3114 is closed in slip ring 3120.Should be appreciated that shank 3112, any one in 3114 can hold active wire, and another can hold return wire.

Figure 53 A-53B shows jaw 3242, and 3244 and another pattern of a part of shank 3212,3214.Wire 3246,3248 is communicated with power source, and can operate with to jaw 3242 thus, and 3244 send bipolarity radio-frequency (RF) energy.Spring contact 3220 can operate optionally provide the electric connection with jaw 3244 by opening wire 3246 when being in the position shown in Figure 53 A.When shank 3212,3214 and jaw 3242,3244 closed time, spring contact 3220 also closes, thus makes energy can be delivered to jaw 3244 as shown in figure 53b.Should be appreciated that can adjustment in use electric current to jaw 3242, other suitable method of 3244, with reference to instruction content herein, this will be apparent for the ordinary skill in the art.

iX. miscellaneous

Should be appreciated that any pattern of apparatus 10 as herein described can comprise in addition to those described or replace those other feature structures various above-mentioned.Only by way of example, any device herein also can comprise one or more in the various lists of references that are incorporated herein by reference various feature structure disclosed in any one.In addition or alternatively, any device herein also can comprise in various feature structures disclosed in following patent one or more: the name submitted on May 2nd, 2012 is called the U.S.Provisional Serial 1/641 of " Electrosurgical Device for Cutting and Coagulating ", 443, its disclosure is incorporated herein by reference.With reference to instruction content herein, will be able to be apparent for the ordinary skill in the art in order to combine the various suitable methods of this type of instruction content.

It is also understood that any device in device described herein can improve, to comprise motor or other electric devices, thus drive the parts of otherwise manual movement.This type of improve various examples the name that on May 10th, 2012 announces be called " Motor Driven Electrosurgical Device with Mechanical and Electrical Feedback " the U.S. announcement 2012/0116379 in have described by, its disclosure is incorporated herein by reference.With reference to instruction content herein, other suitable methods various that motor or other electric devices can be incorporated in any device in this paper device will be apparent to those of ordinary skill in the art.

It is also understood that any device in device as herein described can improve, to comprise the major part (if not all) of required parts in medical treatment device itself.More specifically, device as herein described can be adapted to be and be suitable for using the inner power supply that maybe can be attached, and does not need device to insert external power source by cable.The various examples how medical treatment device can be suitable for comprising compact power are disclosed in the U.S.Provisional Serial 61/410 that the name submitted on November 5th, 2010 is called " Energy-Based Surgical Instruments ", 603, its disclosure is incorporated herein by reference.With reference to instruction content herein, other suitable methods various that power supply can be incorporated in any device in this paper device will be apparent to those of ordinary skill in the art.

Although example is herein mainly with what be described under the background of electrosurgical unit, should be appreciated that various instruction contents herein can be easy to be applied to the device of various other types.Only by way of example, various instruction contents herein can be easy to be applied to the electrosurgical unit of other type, tissue grasper, organized renewing capsule dispose apparatus, surgical stapling device, surgery Clip Applier, ultrasonic surgical instrument etc.It should also be understood that, instruction content herein can be easy to be applied to any apparatus described in any list of references in the list of references quoted herein, and the instruction content of any list of references that instruction content herein can be easy in many ways in the list of references quoted herein is combined.The apparatus of other type that can combine with instruction herein will be apparent for those of ordinary skill in the art.

Should be appreciated that in instruction content described herein, expression way, embodiment, example etc. any one or more can with described herein other instruct in content, expression way, embodiment, example etc. any one or more combine.Therefore above-mentioned instruction content, expression way, embodiment, example etc. should not be considered as being isolated from each other.With reference to present teachings, wherein the combinative various suitable method of present teachings for the ordinary skill in the art will be apparent.This type of amendment and modification are intended to be included in the scope of claims.

Be to be understood that, described any patent, publication or other the open material be incorporated to by reference herein, no matter be full text or part, be only incorporated in the scope that be incorporated to material and the definition provided in the disclosure, statement or other open material do not conflict herein.Thus, under necessary degree, the disclosure clearly set forth herein will replace any afoul material being incorporated to this paper by reference.If according to state be incorporated to by reference herein but with existing definition described herein, statement or the afoul any material of other open material or its part, be incorporated to herein under only not producing the degree of conflicting between be incorporated to material with existing open material.

Device type mentioned above is applicable in regular medication process performed by medical expert and operation, and in the medical care being applicable to robot assisted and operation.Only by way of example, the various instruction contents of this paper can be easy to be incorporated to the DAVINCI such as provided by the Intuitive Surgical company of Sunnyvale, California ^tMin the robotic surgical system of system.Similarly, those of ordinary skill in the art will recognize, various instruction contents herein can be easy to the United States Patent (USP) 6 being called " Robotic Surgical Tool with Ultrasound Cauterizing and Cutting Instrument " with the name announced on August 31st, 2004,783, the various instruction contents of 524 combine, and the disclosure of this patent is incorporated herein by reference.

Pattern mentioned above can be designed to abandon after a single use, or they can be designed to can use repeatedly.In any one or two kinds of situations above-mentioned, all can repair for these patterns, to reuse afterwards at least one times in use.Reparation can comprise the following steps any combination: provision for disengagement, then cleaning or replacing particular elements, and re-assemblies subsequently.Particularly, some patterns in described device can be dismantled, and optionally change with the form of any combination or remove any amount of special order or parts in described device.When cleaning and/or change specific component, some patterns of described device can re-assembly or be re-assemblied for using subsequently by user being about to carry out operation consent in restoration facilities.One skilled in the art will appreciate that device reparation can utilize multiple technologies to carry out dismantling, clean/change and re-assemblying.The use of these technology and gained be repaired device all within the scope of the invention.

Only by way of example, pattern described herein can carry out disinfection before the surgery and/or afterwards.In a kind of disinfection technology, device is placed in closed and container, the such as plastic bag of sealing or TYVEK bag.Subsequently, container and device can be placed in the radiation field of such as gamma-radiation, X-ray or the high energy electron etc. that can penetrate container.Radiation can be killed on device and antibacterial in container.Device after sterilization can leave in disinfecting container subsequently, and also can be used in other technology any as known in the art in order to later use and carry out device sterilization, described technology includes but not limited to β radiation or gamma-radiation, oxirane or vapor sterilization.

Although illustrate and describe multiple pattern in the present invention, those of ordinary skill in the art can carry out suitably amendment without departing from the scope of the present invention to improve further method and system as herein described.Mentioned this type of possible amendments some, and other amendment for a person skilled in the art will be apparent.Such as, example, embodiment, geometry, material, size, ratio, step etc. are all exemplary but not required as discussed above.Therefore, scope of the present invention should be considered according to following claims, and is interpreted as the structure and the details of operation that are not limited to also description shown in description and accompanying drawing.

Claims

1. an equipment, comprising:

(a) first jaw, wherein said first jaw comprises the first electrode surface;

(b) second jaw, described second jaw connects pivotally with described first jaw, wherein said second jaw comprises the second electrode surface, wherein said first jaw and described second jaw can grasping tissues, and wherein said first electrode surface and described second electrode surface are transverse to each other and be biased vertically;

(c) first shank, described first shank is communicated with described first jaw; With

D () second shank, described second shank is communicated with described second jaw, and wherein said first shank and described second shank can operate that described jaw is driven into make position with grasping tissue.

2. equipment according to claim 1, also comprises power source, and wherein said power source can operate to send bipolarity radio-frequency (RF) energy to described first electrode surface and described second electrode surface.

3. equipment according to claim 1, wherein said first jaw comprises first groove that can receive the first plug-in unit, and described second jaw comprises second groove that can receive the second plug-in unit.

4. equipment according to claim 3, also comprises:

A () is arranged on the first plug-in unit in described first groove; With

B () is arranged on the second plug-in unit in described second groove,

Wherein said first plug-in unit and described second plug-in unit comprise transverse to each other and complementary surface biased vertically.

5. equipment according to claim 3, the one or both in wherein said first plug-in unit or described second plug-in unit comprises the pressure that can cut and organize and concentrates feature structure.

6. equipment according to claim 3, wherein said first plug-in unit and described second plug-in unit comprise PTC thermistor part separately.

7. equipment according to claim 3, wherein said first plug-in unit and described second plug-in unit comprise ambroin part separately.

8. equipment according to claim 3, wherein said first plug-in unit and described second plug-in unit limit the passage of the translation cutter that can receive I ellbeam shape separately.

9. equipment according to claim 3, wherein said first groove is at the proximal end place opening of described first jaw, and wherein said second groove is at the proximal end place opening of described second jaw.

10. equipment according to claim 1, wherein said jaw limits central longitudinal axis together, wherein said jaw is laterally placed in the middle along the vertical plane through described longitudinal axis, and wherein said first electrode surface and described second electrode surface can operate with along being horizontally through described longitudinal axis and obliquely until the path of described vertical plane is to tissue delivery bipolarity radio-frequency (RF) energy.

11. equipment according to claim 1, wherein said first jaw comprises a series of electrode surface that replaces and insulated part arranged with checkerboard pattern, and wherein said second jaw comprises a series of electrode surface that replaces and insulated part arranged with the checkerboard pattern of the checkerboard pattern complementation with described first jaw.

12. equipment according to claim 11, also comprise the tusk at the distal end place of described first jaw, and wherein said second jaw comprises can receive described toothed nest.

13. equipment according to claim 1, the outside of wherein said first jaw comprises at least one projection that can perform blunt separation.

14. equipment according to claim 1, also comprise movable cutting element, and wherein said movable cutting element can operate to cut off the tissue be clamped between described first jaw and described second jaw.

15. equipment according to claim 14, also comprise cutting element locking feature structure, wherein said cutting element locking feature structure can operate optionally stop described cutting element to move based on the state of activation of described first electrode surface and described second electrode surface.

16. equipment according to claim 1, also comprise pivot member, described pivot member can operate to limit the motion of described first shank relative to described second shank, wherein said pivot member can operate to allow described first shank to move to partial closed position relative to described second shank when described pivot member is in primary importance, and wherein said pivot member can operate to allow described first shank to move to complete make position from described partial closed position when described pivot member is in the second position.

17. equipment according to claim 16, also comprise the activator button with described pivot member one, wherein said activator button can operate to utilize bipolarity radio-frequency (RF) energy to activate described first electrode surface and described second electrode surface.

18. 1 kinds of equipment, comprising:

(a) first jaw, wherein said first jaw comprises the first electrode surface;

(b) second jaw, described second jaw connects pivotally with described first jaw, and wherein said second jaw comprises the second electrode surface;

(c) cutter, described cutter can be translated across described first jaw and described second jaw;

(d) handle portions, described handle portions is communicated with described second jaw with described first jaw, and wherein said handle portions can operate and make it against described second jaw with closed described first jaw;

(e) trigger, described trigger is arranged on described handle portions, wherein said trigger can make described first jaw and described second jaw energising, and described cutter can also be advanced through described first jaw and described second jaw by wherein said trigger; With

F () locking feature structure, described locking feature structure can operate and optionally stop described cutter to advance with the "on" position based on described jaw.

19. equipment according to claim 18, wherein said locking feature structure comprises the recess be associated with described cutter, and wherein said trigger is biased by the spring to engage described recess, thus stops described cutter to advance.

20. 1 kinds of equipment, comprising:

(a) first jaw, wherein said first jaw comprises current-carrying part and insulative inserts, and wherein said insulative inserts can make a part for described current-carrying part be exposed to provide the first electrode surface;

(b) second jaw, described second jaw connects pivotally with described first jaw, wherein said first jaw comprises current-carrying part and insulative inserts, wherein said insulative inserts can make a part for described current-carrying part be exposed to provide the second electrode surface, the insulating surface of wherein said first jaw is oriented to contact described second electrode surface, and the insulating surface of wherein said second jaw is oriented to contact described first electrode surface; With

C () shank assembly, described shank assembly can operate that described jaw is driven into make position with grasping tissue.